Empowering every family caregiver
Home Health RCM Associate
Location
Philippines
Posted
1 day ago
Salary
0
Seniority
Mid Level
Job Description
Home Health RCM Associate
Abby Care
• 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.
Job 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
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