Authorization Specialist
About Abby Care
Making family care possible. At Abby Care, we are tackling one of the most important and unsolved challenges of our time: family caregiving.
Over 50 million Americans are family caregivers for loved ones without pay, tools, or support. Our mission is clear and ambitious: to train and employ family caregivers so they can get paid for the care they already provide at home.
Abby Care is building a tech-powered, family-first care platform to efficiently deliver care, improve health outcomes, and provide the best-in-class experience nationwide.
We are rapidly expanding our mission and looking for passionate team members to join. Abby Care has partnered with leading insurance plans, healthcare providers, and community organizations. We’re supported by top, mission-driven VCs to empower families throughout the country.
The Role
We're looking for compassionate and dedicated Authorization Specialist to join our Care Delivery team. This is a Full-Time Remote position based in the Greater Philadelphia Area. In this role you will play a crucial role in reviewing intake applications and helping families navigate the authorization process for Abby Care services. Your expertise will ensure that those who need care receive it without added financial stress. We’re seeking someone who embodies our commitment to excellence and shares our core values of empathy and support.
Key Responsibilities:
Managing a team to evaluate and access intakes for program eligibility and to ensure all families' documentation is collected, completed and submitted to the MCO’s accordingly
Review and interpret medical records to ensure timely and accurate prior authorizations, helping families avoid unnecessary delays in care
Maintain high-quality standards and productivity measures in all authorization activities, ensuring families receive the best support
Collaborate with internal and external partners to enhance customer satisfaction and compliance, protecting families from financial burdens
Review applications and payor websites to manage prior authorization, edits, denials and appeals efficiently
The Requirements:
High School diploma or equivalent with two years of prior authorization experience
Strong understanding of medical terminology
Proficiency in Microsoft Office applications and excellent communication skills
Ability to analyze data and exercise independent judgement
Familiarity with MCO regulations for Pennsylvania home health aide (HHA) services is preferred
Our Values
Families First
Redefining healthcare starts with how we treat the parents and children we serve. We go above and beyond for every family, building strong, lasting relationships. We continually ask ourselves, “Would we want this for our own families?”Urgency with Precision
Millions of families are waiting for care, and they cannot wait, therefore this is not your typical 9 to 5 job. We match their urgency with our own, delivering exceptional care without compromise. Here, speed and excellence go hand in hand.Relentlessly Resourceful
As an ambitious startup, we adapt quickly and make the most of limited time and resources. We solve challenges with creativity to deliver results without unnecessary complexity.Purpose with Positivity
We take our mission seriously while never losing sight of the people behind the work. Respect, kindness, memes, and coffee make us stronger as a team and better for the families we serve.Driven to Redefine What’s Possible
We are here to make healthcare better, which means asking hard questions, challenging outdated systems, and finding smarter, more compassionate ways to deliver care.
Benefits:
Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – full-time employees are eligible for an annual company performance bonus.
Comprehensive health coverage that works for you. We cover 90% of your premiums and 70% for your dependents, with multiple PPO plan options to choose from for medical, vision, dental, life, and short-term disability.
Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays.
Team bonding. We love bringing our teams together. As a full-time employee, you’ll get to connect, collaborate, and have fun through team activities and our annual company retreat.
Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).
Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.
We are an equal opportunity employer and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.