About the Role
This role will initially function as a hands-on Revenue Cycle Management (RCM) Lead responsible for establishing billing operations for a newly launched Georgia and New Jersey market. The successful candidate will build processes, conduct payer and regulatory research, create SOPs, and lay the foundation for a scalable RCM department. As the market grows, this role will evolve into a formal people leadership position overseeing billing specialists and offshore team members.
Responsibilities
- Lead the establishment of revenue cycle operations for a newly launched market, including researching payer requirements, workflows, billing processes, and reimbursement guidelines.
- Develop, document, and implement SOPs, workflows, and operational best practices to support future team growth.
- Research and interpret Georgia and New Jersey Medicaid billing requirements and identify operational requirements necessary to support compliance and reimbursement.
- Partner with leadership to define team structure, operational processes, performance metrics, and future KPIs as the department scales.
- Identify process gaps and recommend solutions to improve operational efficiency and future revenue cycle performance.
- Initially operate as an individual contributor while building the foundation of the department.
- Transition into a people leadership role as the Georgia and New Jersey markets expand, including hiring, training, coaching, and managing billing team members.
- Provide mentorship, onboarding support, and performance coaching to future team members.
- Oversee the preparation, submission, and follow-up of insurance claims for home health care services.
- Ensure accurate coding (CPT, HCPCS, ICD-10) and adherence to payer-specific guidelines.
- Monitor and resolve claim rejections, denials, and underpayments promptly.
- Manage accounts receivable to minimize outstanding balances and maximize collections.
- Ensure billing practices comply with federal, state, and payer-specific regulations, including Medicare and Medicaid guidelines.
- Maintain up-to-date knowledge of changes in billing rules and home health care regulations.
- Review documentation for accuracy and completeness to support submitted claims.
- Analyze billing processes and implement strategies to improve efficiency and reduce errors.
- Collaborate with other departments to address issues impacting the revenue cycle, such as intake and documentation workflows.
Requirements
- High school diploma or equivalent required; Associate’s or Bachelor’s degree in a related field preferred.
- Minimum 3-5 years of experience in medical billing, with at least 1-2 years in a supervisory or leadership role.
- Proven expertise in home health care billing, including Medicare and Medicaid processes.
- Experience building, implementing, or improving billing processes and operational workflows is strongly preferred.
- Georgia and New Jersey Medicaid billing experience is a significant advantage.
- Candidates with Home Health, Hospice, or Skilled Nursing billing experience will be considered.
- Intermediate Microsoft Excel proficiency preferred.
- Certified Professional Biller (CPB) or equivalent preferred.
- Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.
Skills
- Excellent organizational, analytical, and problem-solving abilities.
- Exceptional communication and interpersonal skills to lead a team and collaborate across departments.
- Strong research and investigative skills with the ability to gather information independently in a newly established market.
- Demonstrated accountability, including ownership of mistakes, problem resolution, and continuous improvement.
- Strong conflict resolution, coaching, and delegation skills.
- Ability to build processes and operate effectively in an ambiguous, startup-like environment.
Location
- Georgia
- New Jersey
Work Type
- Full-time
Experience Level
- 3-5 years of experience in medical billing
- 1-2 years in a supervisory or leadership role
Education Level
- High school diploma or equivalent
- Associate’s or Bachelor’s degree in a related field preferred
- Certified Professional Biller (CPB) or equivalent preferred
Benefits
- Competitive compensation packages
- Annual company performance bonus
- Comprehensive health coverage (medical, dental, vision)
- PPO with $0 deductible
- Company-funded HSA
- Employer-paid life and disability insurance
- Generous paid time off
- 10 paid company holidays
- HSA contributions
- Optional FSA
- Commuter benefits
- Full coverage of all 401(k) account fees
- Paid parental leave
About the Company
- 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.
- 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?”
- 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.
- 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.
- 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.
- 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.
Equal Opportunity
- We are an equal opportunity employer and welcome applicants from all backgrounds, consistent with applicable laws.
