Home care manager - Claims & Operations Specialist All About You Home Healthcare - 4.6 Albuquerque, NM Job Details Part-time | Full-time $18 - $22 an hour 1 day ago Qualifications Health insurance authorizations Home care experience Staff supervision Team leadership Overseeing healthcare denial management HIPAA Medical billing compliance checks Blue Cross Blue Shield health insurance Medicaid health insurance Records management Attention to detail Medicaid regulations Medical claims submission Medicaid Home healthcare regulations Training Healthcare claims compliance audits Medical claim denial management Process management Documentation review Cross-functional communication Full Job Description All About You Home Health Care is looking for a reliable, experienced Manager to help oversee day-to-day operations and strengthen our billing and claims process. The right person will bring strong leadership, clear communication, and hands-on experience working with Medicaid portals, MCO portals, and AuthentiCare. If you've worked in home-care before and understand the urgency of accurate claims and clean documentation, you'll fit right in. Key Responsibilities You will manage core functions of the agency, including: Overseeing daily office operations and supporting caregivers, clients, and scheduling Monitoring EVV compliance, correcting visit issues, and ensuring all AuthentiCare data matches claims Handling claim submission, claim corrections, and claim resubmissions for all MCOs (Presbyterian, BCBS, Molina, United Healthcare, Western Sky, Lovelace, etc.) Working directly inside Medicaid and MCO portals to fix denials, track payments, review remittance, and resolve billing discrepancies Making sure authorizations are current, accurate, and properly uploaded Communicating with case managers, nurses, and MCO representatives when issues come up Ensuring all documentation is complete, compliant, and audit-ready Reviewing and updating policies, workflows, and operational systems Supporting the schedule team when needed to maintain coverage Reporting progress, issues, and metrics to leadership Requirements Strong background in New Mexico Medicaid billing and claim resubmission Experience using AuthentiCare EVV (required) Experience navigating MCO portals and fixing denials Knowledge of PCS services and home-care operations Strong organizational and problem-solving skills Clear communicator who can work independently Ability to lead, train, and support staff Must be reliable, professional, and detail-oriented Preferred but not required Prior experience as an office manager or operations manager Understanding of HIPAA standards Experience with audits, compliance, and documentation management

Job Types:

Full-time, Part-time Pay:

$18.00 - $22.00 per hour

Work Location:

In person