Home Health RCM Associate
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Job Description
Revenue Cycle Management Support Associate ensuring accurate billing documentation for home health in a remote role. Collaborating with healthcare teams and managing billing processes efficiently.
Responsibilities:
- 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
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