Documentation & Prior Authorization Coordinator

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.

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

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

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

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

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  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

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

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

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

• 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

• 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