Medical Billing Specialist

About Abby Care

Our mission is to redefine care for the most vulnerable. The healthcare system is failing the underserved. We are transforming the healthcare experience for low-income families through cutting edge technology and operations. Abby Care is a leading provider of home health services, dedicated to delivering compassionate, patient-centered care to families and individuals in the comfort of their homes.

What makes us the home health provider of the 21st century:

• Digital health integrations - We innovate to give our clinical teams superpowers. We build technology to decrease clinical administrative work and to improve the measurement of health outcomes.
• Clinical excellence - We strive to deliver the best-in class care to our families. Our culture encourages clinical growth and emphasizes quality in all our clinical processes.
• Family training and support - We believe that family care is key to a patient's wellbeing and health. Our care model incorporates family support into care plans.

The Role

We're looking for an experience individual to join us as a Medical Billing Specialist. You will report into the Director of RCM. This is a Full-Time Remote opportunity based in the United States. A Medical Biller for Home Health Services is responsible for accurately preparing, submitting, and following up on claims to insurance companies, government payers (e.g., Medicare, Medicaid), and patients. This role ensures timely reimbursement for home health services provided, compliance with regulations, and effective communication with healthcare providers and payers.

Key Responsibilities:

Billing and Claims Submission:

• Prepare, review, and submit accurate claims to insurance companies.
• Verify and ensure the accuracy of billing codes (CPT, HCPCS, ICD-10) and modifiers for services rendered.
• Maintain up-to-date knowledge of Medicare, Medicaid, and private insurance billing requirements specific to home health care.
• Use billing software to process and track claims.

Accounts Receivable Management:

• Monitor claim status and follow up on unpaid or denied claims promptly.
• Investigate and resolve claim discrepancies, denials, and appeals.
• Generate reports for outstanding accounts receivable and payment trends.

Compliance and Documentation:

• Ensure all billing practices comply with federal, state, and local regulations.
• Verify patient insurance information, eligibility, and prior authorization requirements.
• Maintain accurate records of billing activities and patient accounts.

Communication and Coordination:

• Collaborate with office staff, and payers to address billing and reimbursement issues.
• Provide clear communication to patients regarding their billing, payments, and financial responsibilities.
• Respond to inquiries from payers, patients, and colleagues in a professional and timely manner.

The Requirements:

Education and Experience:

• High school diploma or equivalent (required); associate’s or bachelor’s degree in a related field (preferred).
• Certification in medical billing and coding (e.g., CPC, CHBME) is highly desirable.
• 1-3 years of experience in medical billing, preferably in a home health care setting.

Skills and Competencies:

• Strong knowledge of home health billing codes, insurance guidelines, and reimbursement processes.
• Proficiency with electronic health records (EHR) and billing software.
• Attention to detail and accuracy in data entry and documentation.
• Excellent problem-solving and organizational skills.
• Strong written and verbal communication skills.

Technical Requirements:

• Familiarity with Medicare and Medicaid billing guidelines specific to home health.
• Experience with claim submission platforms such as Medicare DDE and clearinghouses.
• Knowledge of HIPAA regulations to ensure patient confidentiality.

Our Value Prop to You

• Environment for growth and learning. You will have the opportunity to drive great impact and gain exposure to all functions of the company.
• Propel innovation in healthcare. We are leading the change against traditional providers with outdated systems. You’ll be able to operate in a fast-paced environment to deliver best-in-class care and iterate.
• An energizing, compassionate team. Our team cares deeply about each other. We strive to elevate and uplift each other in our day-to-day work to do the best for our families. We don't believe in bureaucratic nonsense.
• Supporting your well-being. We provide benefits to allow you to do your best work:
• Competitive medical, vision, dental, 401K, and life insurance
• Unlimited paid-time-off (PTO), company holidays, and paid parental leave
• Paid company retreats and travel opportunities

This is a Full-Time role with an estimated range of $50,000 - $60,000 base salary + bonus potential and benefits.