Home Health RCM Associate

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Abby Care

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

👥 B2C

Healthcare Insurance • B2C

Abby Care is a service that helps families get paid for providing in-home care to loved ones with disabilities or special needs. The organization trains and certifies family caregivers at no cost, manages hiring and payroll, navigates Medicaid and insurance paperwork to secure payment, and provides a purpose-built platform, clinical support, and community resources. Abby Care operates in multiple U. S. states and focuses on enabling high-quality, compensated family caregiving through partnerships with insurers and Medicaid programs.

📋 Description

• Review and verify clinical documentation required for claim submission. • Audit home health documentation, including Electronic Visit Verification (EVV), Face-to-Face (F2F) encounters, Plans of Care (CMS-485). • Ensure documentation meets payer and regulatory requirements before billing. • Review EVV records for completeness and accuracy. • Identify missing documentation or discrepancies and coordinate resolution. • Submit EVV data through Medicaid portals and monitor submission status. • Investigate documentation issues that contribute to claim denials. • Partner with billing and operational teams to resolve discrepancies efficiently. • Help minimize billing delays through proactive quality assurance. • Assist with inquiries related to Prior Authorization Requests (PAR) and reauthorizations. • Maintain accurate tracking of billing activities and patient documentation. • Update internal systems to ensure real-time visibility into billing workflows. • Communicate market- or payer-specific billing changes with internal billing teams. • Work closely with Clinical, Operations, and Revenue Cycle teams to resolve documentation issues affecting billing. • Respond professionally and promptly to inquiries from internal stakeholders and payers.

🎯 Requirements

• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field. • 1–3 years of experience in medical billing, revenue cycle management, or healthcare operations. • Experience supporting home health, community-based services, or similar healthcare environments. • Familiarity with Electronic Health Record (EHR) systems. • Strong attention to detail with the ability to identify documentation errors before claim submission. • Excellent analytical, organizational, and communication skills. • Strong understanding of HIPAA regulations and patient confidentiality requirements. • Certification in Medical Billing or Coding (CPC, CHBME, or equivalent). • Experience with Medicare and Medicaid billing. • Familiarity with state-specific Medicaid billing guidelines. • Knowledge of home health reimbursement processes, payer requirements, and revenue cycle workflows. • Experience supporting EVV documentation, prior authorizations, and denial management.

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options