Intake and Authorization Specialist

Paycom - ATS; Town of Florida (NY); On-site; USD 21,000 - 34,000; Full time

Job summary

Paycom - ATS is seeking an Intake & Authorization Specialist in Florida to bridge clients, healthcare providers, and payers. You will manage referrals, verify eligibility, and pursue authorizations while maintaining HIPAA compliance.

You will collaborate with physicians' offices, hospital case managers, and internal teams to ensure timely patient access to care. Preferred candidates have 1–2 years in healthcare admissions, familiarity with Axxess/Nexus CRM, and bilingual English/Spanish

Qualifications

• High school diploma or equivalent required; advanced degree a plus.
• 1–2 years in healthcare admissions, home health intake, medical billing, or insurance authorization.
• Florida home health experience strongly preferred.
• Familiarity with Medicare Advantage, commercial insurance, and managed care payer portals.
• Experience with EMR/CRM systems (Axxess and Nexus CRM desired).
• Bilingual English/Spanish preferred.

Responsibilities

• Process referrals: review incoming Skilled Home Health referrals for completeness.
• Verify insurance eligibility and prior authorization needs; follow up on approvals.
• Identify and escalate missing documentation or discrepancies.
• Maintain documentation in the CRM/EMR systems (Axxess and Nexus CRM).
• Provide updates to physicians' offices, hospital case managers, insurance reps, and internal clinical team.
• Ensure HIPAA compliance and support onboarding/training as needed.

Skills

Attention to detail

Multitasking

Communication

Problem solving

Bilingual English/Spanish

Education

High school diploma or equivalent

Associate or Bachelor’s degree in Healthcare Administration

Tools

Axxess

Nexus CRM

Job description

Job Details: Job Location: Miramar, FL 33025, Salary Range: $22.00 - $25.00 Hourly, About the Role

Are you a detail-oriented healthcare professional with a passion for helping patients access the care they need? We are looking for an Intake & Authorization Specialist to join our Florida team. In this critical role, you will be the bridge between clients, healthcare providers, and insurance payers. You will ensure the timely, accurate, and compassionate handling of Skilled Home Health referrals, laying the foundation for exceptional patient care.

What You’ll Do

• Process Referrals: Receive and review incoming Skilled Home Health referrals for completeness, ensuring all physician orders, clinical documentation, and patient details are accurate.
• Insurance Verification & Authorizations: Verify insurance eligibility and benefits. Determine prior authorization needs, submit requests, and aggressively follow up on pending approvals to prevent any delays in patient care.
• Problem Solve & Escalate: Identify and resolve missing documentation or insurance discrepancies. Proactively elevate complex authorization issues or barriers to timely admission.
• Data & System Management: Maintain meticulous, compliant documentation of referral status, eligibility, and authorization activities in our CRM and EMR systems (Axxess and Nexus CRM).
• Collaborative Communication: Act as a key liaison, providing clear, timely updates to physicians' offices, hospital case managers, insurance representatives, and our internal clinical team.
• Compliance & Support: Maintain strict adherence to HIPAA and regulatory standards. Provide departmental coverage during peak periods and support team onboarding/training as needed.

Qualifications: What We Are Looking For

• Education: High school diploma or equivalent required; Associate or Bachelor’s degree in Healthcare Administration or a related field is a plus.
• Experience: 1–2 years of experience in healthcare admissions, home health intake, medical billing, or insurance authorization. Florida home health experience is strongly preferred.
• Insurance Savvy: Proven familiarity with Medicare Advantage, commercial insurance, and managed care payer portals.
• Tech Skills: Experience navigating EMR/CRM systems (experience with Axxess and Nexus CRM is highly desirable).
• Key Traits: Incredible attention to detail, strong multi-tasking skills in a fast-paced environment, and a proactive approach to solving problems.
• Languages: Bilingual (English/Spanish) is highly preferred.