[Remote] Revenue Cycle Management Operations Lead

Note: The job is a remote job and is open to candidates in USA. Abby Care is building the leading AI-native platform for family-led care, addressing the growing care crisis in America. The Revenue Cycle Management Operations Lead will establish billing operations for newly launched markets in Georgia and New Jersey, develop processes, and eventually transition into a leadership role overseeing billing specialists.

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

Skills

• High school diploma or equivalent required
• 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
• Georgia and New Jersey Medicaid billing experience is a significant advantage
• Candidates with Home Health, Hospice, or Skilled Nursing billing experience will be considered
• 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
• Associate's or Bachelor's degree in a related field
• Experience building, implementing, or improving billing processes and operational workflows
• Intermediate Microsoft Excel proficiency
• Certified Professional Biller (CPB) or equivalent

Benefits

• Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – full-time employees are eligible for an annual company performance bonus.
• Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance.
• Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays.
• Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).
• Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.

Company Overview