Home Health RCM Associate

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.

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

• 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.

• 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.

• 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.

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.

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.