Documentation & Prior Authorization Coordinator

Abby Care

Boston

On-site

PHP 2,774,000 - 4,007,000

Full time

7 days ago
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Benefits offered by this job

Competitive compensation packages
Comprehensive health coverage (medical
Generous paid time off
Financial savings benefits (HSA, FSA)
Paid parental leave

Job summary

Abby Care in Boston, MA is hiring a Documentation & Prior Authorization Coordinator to collect, verify, and track documents to onboard families and keep cases compliant. You will communicate with families and provider offices by phone, fax, text, and email to guide them through the process and keep AbbyOS and Salesforce V3 records current.

This is a full-time hybrid role based in Boston, requiring attention to detail, HIPAA awareness, and the ability to handle a high volume of daily calls with

Qualifications

  • Experience in customer service, administrative support, or healthcare operations.
  • Experience in patient advocacy, insurance coordination, or similar healthcare support roles.
  • Familiarity with HIPAA, Medicaid, and healthcare documentation standards.
  • Ability to manage high-volume inbound and outbound calls in a fast-paced environment.
  • Strong attention to detail and organizational skills, particularly for cross-checking hours and dates across multiple documents.
  • Ability to perform repetitive tasks accurately while meeting deadlines.
  • Strong process improvement mindset and operational efficiency focus.
  • Excellent verbal and written communication skills.
  • Compassionate and professional when working with patients, families, and caregivers.

Responsibilities

  • Communicate clearly and compassionately with families via phone, text, and email.
  • Collect, review, and track required documentation from caregivers and families (e.g., IDs, certifications, health records, LMNs, etc).
  • Ensure all documents are accurate, complete, and compliant with state and Medicaid/Medicare regulations.
  • Maintain organized records and track expiring documents, sending timely reminders.
  • Make outbound calls and respond to inbound inquiries to guide families and provider offices through the documentation process, following Abby Care's standard call scripts.
  • Handle a high volume of phone interactions daily (50 to 70 calls) while maintaining professionalism, empathy, and efficiency.
  • Collaborate with onboarding, credentialing, and family support teams to deliver a smooth experience.
  • Maintain confidentiality of all patient and caregiver information in line with HIPAA and Abby Care data handling policy.

Skills

Customer service
Healthcare operations
Patient advocacy
Insurance coordination
HIPAA knowledge
High-volume calls
Attention to detail
Communication
Organization
Process improvement
Empathy

Tools

Salesforce V3

Job description

About Abby Care: Powering the future of care at home for all of America.

Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever. Over 50 million family caregivers support loved ones without the tools, training, or recognition they deserve.


We believe families are the largest untapped caregiving workforce in America, and that technology can help them deliver better care while driving stronger outcomes and greater transparency across the healthcare system.


Abby Care combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers in delivering high-quality care at home. Our platform helps health plans and government partners better understand, verify, and improve care in the home. We expand access to care, reduce reliance on higher-cost settings, and help ensure public dollars are spent effectively.


We are proud to partner with leading health plans, providers, and community organizations and are backed by top VCs. We envision a future where family-led care is a core part of the healthcare system. Abby Care is building that future.


Join us in solving one of the most important challenges of our time.


The Role

The Documentation & Prior Authorization Coordinator will support families and caregivers by collecting, verifying, and tracking the necessary documents to onboard families and keep active cases in compliance. These could include IDs, MassHealth/MCO documentation, licensure and certification records, and clinical documents like the 485 and LMN. You will be highly communicative by phone, fax, text, and email to guide families and provider offices through the process, catch errors before they cause a denial, and keep AbbyOS and Salesforce V3 records current.


This is a Full-Time Hybrid opportunity based in Boston, MA.


Key Responsibilities



  • Communicate clearly and compassionately with families via phone, text, and email


  • Collect, review, and track required documentation from caregivers and families (e.g., IDs, certifications, health records, LMNs, etc).


  • Ensure all documents are accurate, complete, and compliant with state and Medicaid/Medicare regulations


  • Maintain organized records and track expiring documents, sending timely reminders.


  • Make outbound calls and respond to inbound inquiries to guide families and provider offices through the documentation process, following Abby Care's standard call scripts


  • Handle a high volume of phone interactions daily (50 to 70 calls) while maintaining professionalism, empathy, and efficiency


  • Collaborate with onboarding, credentialing, and family support teams to deliver a smooth experience


  • Maintain confidentiality of all patient and caregiver information in line with HIPAA and Abby Care data handling policy



The Requirements


  • Experience in customer service, administrative support, or healthcare operations


  • Experience in patient advocacy, insurance coordination, or similar healthcare support roles


  • Familiarity with HIPAA, Medicaid, and healthcare documentation standards


  • Ability to manage high-volume inbound and outbound calls in a fast-paced environment


  • Strong attention to detail and organizational skills, particularly for cross-checking hours and dates across multiple documents


  • Ability to perform repetitive tasks accurately while meeting deadlines


  • Strong process improvement mindset and operational efficiency focus


  • Excellent verbal and written communication skills


  • Compassionate and professional when working with patients, families, and caregivers



Nice to have



  • Prior authorization experience and healthcare industry exposure preferred


  • Experience with Salesforce V3 and fax-based document workflows


  • Spanish fluency preferred, given the population served


  • Associate or Bachelor's degree in a healthcare-related field


  • Knowledge of medical and insurance authorization terminology



Benefits:


  • Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work.


  • Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance.


  • Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays.


  • 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 up to 10 weeks of paid parental leave based on tenure, so you can focus on bonding and adjusting to life as your family grows.



Our Values


  1. 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?”


  2. 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.


  3. 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.


  4. 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.


  5. 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.



Automated Decision Tools


Abby Care may use automated decision tools to help match and rank candidate work experience, education and skills found in online profiles, resumes and job applications against job requirements. We believe that these tools help ensure objective, data-based decisions during the hiring process, however, all Abby Care hiring decisions involve final human review and input. If you have questions or would like to request an alternative process, contact talent@abbycare.org.

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