Job description

About Abby Care

Our mission is to redefine care for the most vulnerable families. We are transforming home health through purpose-built, thoughtful technology and a unique care model with families at the core.

What makes us the home health provider of the 21st century:

Digital health integrations - We innovate to give our clinical teams superpowers. We build technology to decrease clinical administrative work and to improve the measurement of health outcomes.
Clinical excellence - We strive to deliver the best-in class care to our families. Our culture encourages clinical growth and emphasizes quality in all our clinical processes.
Family training and support - We believe that family care is key to a patient's wellbeing and health. Our care model incorporates family support into care plans.

The Role

We're looking for an organized and efficient Intake Specialist to join our healthcare team. This is a Full-Time Remote position based in Miami, FL. As an Intake Specialist at Abby Care, you’ll play a crucial role in reviewing intake applications and helping families navigate the authorization process for Abby Care services. We’re seeking someone who embodies our commitment to excellence and shares our core values of empathy and support.

Key Responsibilities:

Assess and process intakes to determine program eligibility, ensuring that all required family documentation is collected, completed, and submitted accurately to Florida Medicaid and Managed Care Organizations.
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 efficiently manage prior authorization, edits, denials and appeals.

The Requirements:

2+ years of prior authorization experience
1+ years of experience assessing pediatric referrals
Experience working with Home Health Agencies or Private Duty Nursing is preferred
Licensed Practical Nurse (LPN) or Registered Nurse (RN) preferred
Bilingual in Spanish is preferred

Who We're Looking For:

This role would be a fit for you if you have the following:

Compassion: A deep commitment to providing empathetic and patient-centered care.
Integrity: Upholds the highest standards of ethical and professional behavior.
Resilience: Ability to remain positive and motivated in a dynamic and challenging environment.
Team Player: Collaborative and supportive, with a strong focus on team success.
Continuous Learner: Open to feedback, willing to learn, and committed to ongoing professional development.