Jobs at Abby Care

Collects, verifies, and tracks caregiver, family, insurance, certification, and clinical documentation for onboarding and active-case compliance. Communicates with families and provider offices through phone, text, email, and fax; manages 50–70 daily calls; identifies documentation errors, monitors expirations, sends reminders, maintains AbbyOS and Salesforce V3 records, and protects patient information under HIPAA and applicable healthcare regulations.

Conduct outbound calls to prospective caregivers, guide them through intake, explain services, collect documentation, schedule training, and set them up in ADP and related systems. Maintain caregiver relationships through onboarding, answer questions, document interactions in Salesforce and Regal, track follow-ups, and collaborate with nursing and care operations teams. The role requires high-volume communication, empathy, organization, persuasion, and adaptability in a startup environment.

Serve as the primary compliance owner for a 2-3 state cluster: localize policies, prepare for and respond to licensure surveys/audits, monitor state regulatory changes, deliver state-specific training, execute monitoring and remediation, and partner closely with operations leadership to ensure regulatory adherence across Medicaid home health, HCBS waivers, and family caregiver services.

Lead and manage end-to-end prior authorization and reauthorization operations for Massachusetts LTSS/LTHH waiver programs. Ensure compliance, no lapses in patient care, resolve complex Medicaid authorizations and appeals, partner cross-functionally to protect revenue lifecycle, and train/mentor staff to meet performance metrics and processing SLAs.

Prepare, submit, and follow up on home health claims; verify coding (CPT/HCPCS/ICD-10), manage AR, resolve denials/appeals, maintain compliance with Medicare/Medicaid and HIPAA, and communicate with payers, patients, and internal teams.