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 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. KEY RESPONSIBILITIES 1. CLAIMS PREPARATION & SUBMISSION * 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. 2. BILLING, PAYROLL, & REVENUE CYCLE SUPPORT * 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. 3. SYSTEMS & DOCUMENTATION * 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. 4. COLLABORATION & COMMUNICATION * 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). ROLE REQUIREMENTS (NON-NEGOTIABLES) * Experience: 2–3 years of experience in U.S. medical billing. * RCM Knowledge: Strong understanding of the Revenue Cycle Management (RCM) process. * Coding Proficiency: Experience with CPT codes, diagnosis codes, revenue codes, and place-of-service codes. * Claim Submission: Experience preparing and submitting insurance claims with the ability to process high claim volumes while maintaining accuracy. * Industry Background: 1+ year of Home Health billing experience. * Technical Skills: Proficiency in Excel/Google Sheets and EHR/EMR systems. Comfortable working with multiple systems and technologies using dual monitors and screen-sharing tools. * Soft Skills: Excellent attention to detail, strong organizational skills, and the ability to follow detailed instructions. * Language: Strong written and spoken English communication skills. PREFERRED QUALIFICATIONS (NICE-TO-HAVE) * Experience with Medicaid billing. * Experience working in remote or distributed teams. * Experience with CollaborateMD (CMD). * Familiarity with tools such as Availity, NaviNet, Waystar, NextGen, or Avaya. PERFORMANCE METRICS Success in this role will be measured by: * Number of claims processed daily. * Accuracy of claim submissions and low error rates. * Clean claim rate. * Overall productivity and adherence to billing processes. Other Details: * Location: Remote (Open to candidates from the Philippines) * Schedule: 9:00 AM – 5:00 PM EST BENEFITS: * Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – global team members are eligible for an annual company performance bonus. * Generous paid time off. We provide 15 days of paid time off that allow you to recharge, along with 10 paid company US holidays. * Growth Opportunities. Build your leadership skills while working with teams in various markets across the US.   We are an equal opportunity employer and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.   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 [email protected].