Home Health Medical Billing Specialist

The Home Health Medical Billing Specialist supports critical components of the Revenue Cycle Management (RCM) process, focusing on claim entry, billing validation, and prebilling payroll quality assurance. This role bridges the gap between home health aide (HHA) hours and accurate insurance billing, ensuring that compliance and efficiency remain at the highest standards.

• Review and prepare medical claims for submission to insurance providers.

• Ensure all required CPT, diagnosis, revenue codes, and place-of-service codes are accurate before claims are submitted.

• Convert Electronic Visit Verification (EVV) records into billable claims within the billing platform.

• Enter and manage 60–75 claims per day while maintaining high accuracy.

• Conduct weekly payroll Quality Assurance (QA) of HHA hours to ensure accurate pay.

• Perform weekly QA of HHA visits to be sent for billing to Managed Care Organizations (MCOs), executing quality checks to ensure charted and worked hours match the hours authorized by the health plan.

• Support key components of the Revenue Cycle Management (RCM) process, with a primary focus on claim entry and billing.

• Verify that claims contain complete and accurate billing information prior to submission and assist with Coordination of Benefits (COB) when applicable.

• Monitor claims to ensure compliance with payer requirements.

• Enter and manage claims within billing systems such as CollaborateMD (CMD).

• Maintain accurate records within the billing platform and related systems.

• Utilize multiple systems simultaneously and work effectively using dual monitors and screen-sharing tools.

• Communicate with internal teams regarding billing documentation or claim issues.

• Follow established billing workflows and escalate issues when necessary.

• Maintain clear and professional communication in English (written and spoken).

• 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.

• 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.

• 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  We are here to make healthcare better, which means asking hard questions, challenging outdated systems, and finding smarter, more compassionate ways to deliver care.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.