[Hiring] Authorization Specialist @Abby Care

Role Description

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.

• 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.

Qualifications

• 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.

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.

Company Description

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.