Home Health RCM Associate

 Posted an hour ago
     
2-5 years experience
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AI Summary

The role focuses on auditing clinical documentation and EVV records to ensure accuracy and compliance before submitting claims for reimbursement. It involves collaborating with clinical and operations teams to resolve billing blockers and minimize claim denials.

About Abby Care: Powering the future of care at home for all of America.


Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever. Over 50 million family caregivers support loved ones without the tools, training, or recognition they deserve.

We believe families are the largest untapped caregiving workforce in America, and that technology can help them deliver better care while driving stronger outcomes and greater transparency across the healthcare system.

Abby Care combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers in delivering high-quality care at home. Our platform helps health plans and government partners better understand, verify, and improve care in the home. We expand access to care, reduce reliance on higher-cost settings, and help ensure public dollars are spent effectively.

We are proud to partner with leading health plans, providers, and community organizations and are backed by top VCs. We envision a future where family-led care is a core part of the healthcare system. Abby Care is building that future.

Join us in solving one of the most important challenges of our time.

About the Role

We are looking for a detail-oriented Revenue Cycle Management (RCM) Support Associate to support the home health billing process by ensuring all required clinical documentation is accurate, complete, and compliant before claims are submitted for reimbursement.

In this role, you will work closely with the Revenue Cycle Management, Clinical, and Operations teams to identify documentation issues, resolve billing blockers, and support timely claim submissions to Medicare, Medicaid, and other insurance payers. Your work will directly contribute to improving reimbursement timelines, reducing denials, and maintaining regulatory compliance.

What You'll Do

Billing & Claims Support

  • 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.

EVV Quality Assurance

  • 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.

Denial Prevention & Resolution

  • 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.

Prior Authorization Support

  • Assist with inquiries related to Prior Authorization Requests (PAR) and reauthorizations.

  • Maintain working knowledge of authorization requirements for home health service lines, including CNA, IHSS, and PASA services.

Data & Process Management

  • Maintain accurate tracking of billing activities and patient documentation.

  • Update internal systems to ensure real-time visibility into billing workflows.

  • Stay informed of payer updates, billing requirements, and reimbursement processes.

  • Communicate market- or payer-specific billing changes with internal billing teams.

Cross-Functional Collaboration

  • 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.

What We're Looking For

Required Qualifications

  • 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.

Preferred Qualifications

  • 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.

What Success Looks Like

Successful candidates will:

  • Consistently maintain accurate and complete billing documentation.

  • Help reduce billing delays and prevent claim denials.

  • Ensure compliance with payer and regulatory requirements.

  • Communicate effectively across Operations, Clinical, and Billing teams.

  • Demonstrate exceptional attention to detail and ownership of assigned workflows.

Our Values

  1. Families First
    Redefining healthcare starts with how we treat the parents and children we serve. We go above and beyond for every family, building strong, lasting relationships. We continually ask ourselves, “Would we want this for our own families?”

  2. Urgency with Precision
    Millions of families are waiting for care, and they cannot wait, therefore this is not your typical 9 to 5 job. We match their urgency with our own, delivering exceptional care without compromise. Here, speed and excellence go hand in hand.

  3. Relentlessly Resourceful
    As an ambitious startup, we adapt quickly and make the most of limited time and resources. We solve challenges with creativity to deliver results without unnecessary complexity.

  4. Purpose with Positivity
    We take our mission seriously while never losing sight of the people behind the work. Respect, kindness, memes, and coffee make us stronger as a team and better for the families we serve.

  5. Driven to Redefine What’s Possible
    We are here to make healthcare better, which means asking hard questions, challenging outdated systems, and finding smarter, more compassionate ways to deliver care.

Automated Decision Tools

Abby Care may use automated decision tools to help match and rank candidate work experience, education and skills found in online profiles, resumes and job applications against job requirements. We believe that these tools help ensure objective, data-based decisions during the hiring process, however, all Abby Care hiring decisions involve final human review and input. If you have questions or would like to request an alternative process, contact talent@abbycare.org.

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