Careers

Location: Remote – Philippines
Department: Revenue Cycle Management (RCM)
Reports To: Associate Director / Director of Revenue Cycle Management

Position Overview

The Client Success Manager is responsible for overseeing the financial and operational success of assigned client accounts by ensuring efficient revenue cycle management, regulatory compliance, and exceptional client service. This role serves as the primary account-level leader, partnering with internal teams and agency stakeholders to optimize reimbursement performance, reduce denials, improve accounts receivable (AR) outcomes, and maintain operational excellence.

The ideal candidate combines strong leadership, healthcare revenue cycle expertise, analytical skills, and client relationship management experience. They will work closely with Team Leads, Quality Assurance, Training, Production, and Executive Leadership to ensure timely reimbursements, minimize denials and AR aging, maintain payer compliance, and drive continuous process improvement. This position is critical to sustaining the financial health of partnered home care, home health, and hospice agencies while fostering collaboration across clinical and non-clinical departments.

Key Responsibilities

Client Success & Account Management

• Serve as the primary operational point of contact for assigned client accounts.
• Address urgent client and staff escalations daily to ensure timely issue resolution.
• Lead recurring revenue cycle meetings with agency stakeholders and internal Team Leads.
• Provide account-level performance updates and strategic recommendations to clients.
• Develop and maintain client-specific dashboards illustrating billing cycle performance and revenue health.
• Prepare high-level revenue forecasting reports and data summaries for agency administrators.
• Build trusted client relationships through proactive communication and operational transparency.

Revenue Cycle Operations

• Review claim submission queues and aging AR reports across assigned accounts.
• Ensure Notices of Admission (NOA), Notices of Election (NOE), claims, and remittances are processed accurately and promptly.
• Complete root cause analysis of AR by payer, denial reason, and aging bucket.
• Coordinate with production teams to resolve claims aged over 90 days.
• Track denial trends and implement corrective action plans while partnering with agencies to eliminate upstream process deficiencies.
• Identify variances in expected reimbursement, payment trends, or claim volumes and escalate findings appropriately.
• Review production logs to identify unusually high or low dollar transactions requiring Quality Assurance review.

Operational Leadership

• Collaborate with Team Leads and Quality Assurance to review account trends, team capacity, productivity, and quality metrics.
• Conduct regular team huddles along with the Associate Director to discuss workflow updates, priorities, bottlenecks, and operational improvements.
• Adjust job responsibilities or shift assignments based on staffing levels, workload, and client needs in collaboration with the Associate Director and Director.
• Develop cross-training plans to maintain continuity of service during employee absences.
• Encourage collaboration and peer-to-peer problem solving while escalating issues appropriately.
• Review career development plans for employees below the manager level and recommend internal promotions to leadership when appropriate.

Compliance & Quality Assurance

• Ensure billing operations comply with CMS regulations and payer-specific billing requirements.
• Respond immediately to compliance concerns identified through audits or staff reporting.
• Update billing procedures and workflows in response to regulatory or payer policy changes.
• Clarify payer requirements and documentation expectations for complex billing situations.
• Resolve escalated claim and payment disputes collaboratively with internal teams and clients.

Process Improvement & Technology

• Monitor technology issues affecting billing operations and ensure timely resolution of ticketed system problems.
• Identify workflow bottlenecks and implement short-term operational improvements while working on long-term solutions.
• Call Electronic Health Record (EHR) and clearinghouse vendors to evaluate system performance and optimization opportunities.
• Recommend automation initiatives and workflow enhancements to improve billing, AR and payment posting efficiency.
• Evaluate existing systems for operational gaps and present recommendations for continuous improvement.

Reporting & Performance Management

• Send regular account-level performance snapshots to leadership and Team Leads.
• Review account performance metrics and discuss outliers with the Associate Director and Director.
• Analyze operational data to identify revenue trends, productivity opportunities, and financial risks.
• Monitor account KPIs and ensure assigned accounts consistently meet organizational performance goals.

Training & Staff Development

• Partner with Training and Quality Assurance teams to identify knowledge gaps.
• Host focused micro-training sessions covering trending denial reasons, payer updates, documentation requirements, and operational best practices.
• Promote a culture of continuous improvement, accountability, professional development, and whole team mindset.

Qualifications

Required

• Degree in Healthcare Administration, Business Administration, Finance, or a related field, or equivalent work experience.
• Minimum 3 years of experience in healthcare revenue cycle management, medical billing, or accounts receivable.
• Minimum 1 years of leadership, client success, or account management experience.
• Strong knowledge of Medicare, Medicaid, commercial insurance, CMS regulations, and payer-specific billing requirements.
• Experience supporting Home Care, Home Health, Hospice, or post-acute healthcare organizations required.
• Advanced proficiency in Microsoft Excel, reporting tools, and data analysis.
• Experience working with EHR systems, clearinghouses, and revenue cycle software.
• Excellent verbal and written English communication skills.
• Strong analytical, organizational, and problem-solving abilities.
• Ability to manage multiple client accounts in a fast-paced remote environment.

Job Title: RN Hybrid Intake Coordinators (Clinical and Non-Clinical)
Shift: Nigh Shift Philippines Time
Permanent Remote Set up- Philippine-based applicants only

Clinical & Non-Clinical Intake Duties

Referral Assessment

• Review clinical documentation to determine eligibility under home health and hospice guidelines.
• Ensure necessity of care is justified and supported by medical records.

Insurance Verification & Authorization

• Verify patient insurance coverage and benefits.
• Coordinate with authorization teams to secure approvals.

Chart Creation & Documentation Management

• Create patient charts in MatrixCare (EMR) systems.
• Collect and organize discharge paperwork, face-to-face encounter notes, consult notes, facesheets, demographics, insurance information, and medical history.
• Ensure completeness of documentation before SOC (Start of Care) admission.

Physician & Clinical Coordination

• Confirm MD orders and physician involvement.
• Communicate with RN supervisors, case managers, clinicians, marketers, social workers, and medical assistants.
• Conduct background checks on patients to ensure clinician safety.

Patient & Family Engagement

• Conduct welcome calls to patients and families.
• Answer questions related to SOC admission.

Stakeholder Collaboration

• Coordinate with business development teams, marketers, social workers, scheduling teams, and other stakeholders to ensure smooth patient onboarding.
• Route incoming calls to appropriate departments and handle home health/hospice referrals and SOC admission-related concerns.
• Provide updates regarding hospitalization status and transitions of care.

Hospitalization Monitoring

• Track patient hospitalizations and communicate updates to all staff involved in care.

Portal & System Management

• Navigate referral portals (Epic, CarePort Allscripts, CarePort Navi, Ensocare).
• Use insurance portals (Availity, UHC, NGSConnex, CT DSS).
• Access SNF/ALF portals (PointClickCare).

Communication Management

• Handle email and fax correspondence related to referrals and admissions.
• Follow up with providers for missing or incomplete documentation.

Additional Responsibilities (to ensure completeness)

Compliance & Quality Assurance

• Ensure intake processes comply with CMS, state, and payer regulations.
• Maintain HIPAA compliance in all communications and documentation.

Process Improvement

• Identify bottlenecks in intake workflow and recommend improvements.
• Support training of new intake staff when needed.

Cross-Coverage

• Provide backup support to other intake coordinators during high-volume periods.
• Assist with both home health and hospice admissions interchangeably.

Qualifications

• Must be an RN with at least 1 year experience in a hospital setting.
• Background in healthcare intake coordination (home health and/or hospice preferred).
• Strong knowledge of medical documentation, insurance verification, and referral processes.
• Proficiency in EMR systems and referral/insurance portals.
• Excellent communication and multitasking skills.
• Ability to collaborate across clinical and non-clinical teams.

Location: Kochi
Reports To: CEO
Job Type: Full-time

We are seeking an experienced and strategic Manager – Corporate Finance to lead our financial operations and support business growth. The ideal candidate will have strong expertise in U.S. accounting, financial management, and compliance, along with the ability to partner with leadership on key business decisions.

RESPONSIBILITIES

• Lead global finance strategy, budgeting & forecasting
• Oversee accounting, compliance & audits across regions
• Manage cash flow, costs & overall P&L performance
• Strengthen financial controls & governance
• Partner with leadership for strategic decisions
• Drive growth, profitability & value creation

REQUIREMENTS:

• Bachelor’s degree in Accounting, Finance or related field; CA preferred
• 5+ years of hands-on U.S. accounting experience, including month-end close and financial statement preparation
• Proven track record managing accounts receivable for U.S.-based businesses
• Expert-level proficiency in QuickBooks and advanced Excel/Google Sheets
• Deep understanding of U.S. GAAP, IRS regulations and tax-reporting requirements

Location: Kochi
Reports To: Digital Marketing Manager
Job Type: Full-time

We are looking for a proactive and creative Digital Marketing Executive to join our Kakkanad, Kochi Office. The ideal candidate should be a quick learner with a strong aptitude for emerging technologies like AI and IoT, and a passion for digital marketing. This role involves managing social media, creating engaging content, and implementing SEO strategies to enhance brand visibility.

Responsibilities

• Create engaging, high-quality content and narratives
• Manage and grow the company’s LinkedIn presence, including profiles of key personnel
• Plan and execute social media strategies to improve reach and engagement
• Implement SEO strategies based on a solid understanding of search engine optimization
• Use SEO tools to generate and optimize content for better search rankings
• Monitor website performance and apply SEO best practices across different sections
• Run and manage campaigns on platforms like Google Ads
• Prepare and present performance reports using predefined templates
• Conduct outreach and build visibility through LinkedIn and other channels

Requirements

• Bachelor’s degree in any discipline
• 2–3 years of experience in digital marketing
• Agency experience is preferred
• Hands-on experience with SEO and tools like Google Ads
• Familiarity with LinkedIn marketing and personal branding strategies
• Basic understanding of AI tools and their application in marketing
• AI certifications will be an added advantage
• Strong communication and content creation skills
• Ability to learn quickly and adapt in a fast-paced environment

Job Title: Home Health Medical Billers
Job Type: Full-time
Location: Philippines- Remote
Shift: Night Shift

Job Description:
Experienced Home Health Medical Biller with at least two (2) years of experience in home health billing and proficient in billing platforms such as Kinnser/WellSky, KanTime, AlayaCare, Careficient, and/or Alora Plus (required). Employees will have a strong understanding of insurance claims processing, Medicare/Medicaid billing, private insurance, and compliance regulations.

Responsibilities:

• Track and collaborate with the agency where needed to ensure accurate start of care information to be able to submit all NOAs in a timely manner.
• Verify patient insurance coverage and eligibility before claim submission, after services are rendered. This does not include the eligibility checks for referrals or admissions/intake of new patients, nor the bi-monthly maintenance of proactive eligibility checking.
• Accurately process and submit claims for home health services through the agency utilized billing platforms such as Kinnser/WellSky, KanTime, AlayaCare, Careficient, and/or Alora Plus.
• Complete a post bill audit to see if claims are rejected at the clearinghouse level. Resolve any rejections in a timely manner and ensure claims have been accepted by the payer.
• Work with the internal Cliniqon RCM accounts receivable team for any claim corrections needed on denied claims to resolve denials or rejections in a timely manner, with resubmission.
• Assist the team leads in generating billing reports for the agency as needed.
• Ensure compliance with HIPAA regulations and billing guidelines.
• Collaborate with teams, including clinical and administrative staff, to resolve billing discrepancies. This includes internal Cliniqon teams when additional service lines are contracted, and external to Cliniqon teams at the agency.

Requirements:

• Minimum 2 years of experience in home health medical billing.
• Proficiency in billing platforms such as Kinnser/WellSky, KanTime, AlayaCare, Careficient, and/or Alora Care.
• Strong knowledge of Medicare, Medicaid, and private insurance billing for home health services.
• Familiarity with medical coding (HCPCS, ICD-10, CPT) and compliance regulations.
• Excellent communication and problem-solving skills.
• Ability to work independently and manage multiple tasks efficiently.
• Ability to work collaboratively with multiple teams.

Preferred Qualifications:

• Experience with Electronic Medical Records (EMR) systems.
• Knowledge of OASIS documentation and home health agency regulations.
• Prior experience working in a high-volume billing environment.

Location: Kochi (Work from office only)
Reports To: Product Manager
Job Type: Full-time (10 a.m. – 7:00 p.m. IST)

Job Summary:

The Python Developer is responsible for designing, developing, and maintaining Python-based applications and services. This role involves building and consuming RESTful APIs, writing clean and well-documented code, and collaborating with product, QA, and DevOps teams to deliver high-quality solutions. The developer troubleshoots and optimizes application performance, participates in code reviews following best practices, and provides production support by resolving issues and implementing necessary fixes.

Key Responsibilities:

• Design, develop, and maintain Python-based applications and services.
• Build and consume RESTful APIs.
• Write clean, efficient, and well-documented code.
• Collaborate with product, QA, and DevOps teams to deliver high-quality solutions.
• Debug, troubleshoot, and optimize application performance.
• Participate in code reviews and follow best practices.
• Support production issues and implement fixes as needed.

Qualifications and Skills:

• Bachelor’s degree in Computer Science or a related field.
• 3–4 years of experience in Python development.
• Strong proficiency in Python frameworks (Django, Flask, FastAPI).
• Experience with REST APIs and microservices architecture.
• Solid understanding of databases (SQL, PostgreSQL, MySQL is a plus).
• Familiarity with Git and version control practices.
• Experience working in MS and Linux environments.

Preferred Experience:

• Exposure to cloud platforms (AWS, Azure, GCP).
• Basic knowledge of Docker and CI/CD pipelines.
• Experience with message queues (Kafka, RabbitMQ).
• Domain experience in healthcare or enterprise applications

Location: Kochi (Work from office only)
Reports To: Product Manager
Job Type: Full-time (10 a.m. – 7:00 p.m. IST)

Job Summary:

The ML Engineer is responsible for designing, developing, and deploying AI/ML models to support healthcare data processing and automation. This role focuses on building NLP-based solutions for clinical text analysis, coding validation, and documentation quality improvement, while enhancing medical coding accuracy, compliance, and productivity. The engineer integrates AI models with EMR/EHR systems and internal applications, collaborates with QA, coding, and compliance teams to translate business requirements into AI logic, and implements model monitoring, retraining, and performance evaluation processes.

Key Responsibilities:

• Design, develop, and deploy AI/ML models for healthcare data processing and automation.
• Build NLP-based solutions for clinical text analysis, coding validation, and documentation quality checks.
• Develop AI models to assist with medical coding accuracy, compliance, and productivity.
• Integrate AI models with EMR/EHR systems and internal healthcare applications.
• Collaborate with QA, coding, and compliance teams to translate business rules into AI logic.
• Implement model monitoring, retraining, and performance evaluation processes.
• Ensure solutions comply with HIPAA and healthcare data security standards.
• Support continuous improvement by refining models based on real-world feedback.

Qualifications & Skills:

• Bachelor’s or Master’s degree in Computer Science, AI, Data Science, or a related field.
• 3–6 years of experience in AI/ML development.
• Strong hands-on experience with Python and ML frameworks
• Experience with NLP techniques (transformers, LLMs, text classification, entity extraction, prompting).
• Solid understanding of data preprocessing, feature engineering, and model evaluation.
• Experience deploying models in cloud environments (Azure or AWS).
• Familiarity with MLOps tools (CI/CD, model versioning, monitoring).

Preferred Experience:

• Experience in healthcare coding (ICD-10, CPT, HCPCS).
• Exposure to OASIS, PDGM, home health, or clinical documentation workflows.
• Experience working with EMR/EHR systems.
• Understanding of healthcare compliance and audit processes (ADR, QA, medical necessity).
• Experience with rule engines + AI hybrid solutions.
• Nice to Have
• Experience with LLMs (OpenAI, open-source models, prompt engineering).
• Knowledge of FHIR/HL7 healthcare standards.
• Experience in building AI-powered dashboards or decision-support tools.
• Prior experience in healthcare product development.

Location: Kochi (Work from office only)
Reports To: Product Manager
Job Type: Full-time (10 a.m. – 7:00 p.m. IST)

Job Summary:

The .NET Developer is responsible for designing, developing, and maintaining scalable web applications using .NET technologies such as C#, ASP.NET, MVC, and .NET Core. This role involves writing clean and efficient code, managing and optimizing SQL Server databases, and ensuring high code quality through reviews, testing, and best practices. The developer collaborates with cross-functional teams including QA, DevOps, and UI/UX, participates in Agile/Scrum processes, and takes ownership of modules from design through production deployment. Additionally, the position includes maintaining technical documentation, providing post-deployment support, and troubleshooting Azure-related environment issues to ensure application reliability and performance.

Key Responsibilities:

Software Development:

• Design, develop, and maintain web applications using .NET technologies (C#, ASP.NET, MVC, .NET Core, etc.).
• Write clean, scalable, and efficient code following best practices.
• Collaborate with the team to develop new features, troubleshoot issues, and optimize performance.

Database Management:

• Work with SQL Server or other databases to design, create, and optimize database structures.
• Write and optimize complex queries, stored procedures, and triggers.
• Code Review and Quality Assurance:
• Conduct peer code reviews to ensure adherence to development standards.
• Test software components to identify bugs and improve performance.
• Implement unit tests, integration tests, and automate testing where applicable.
• Collaboration and Communication:
• Collaborate with cross-functional teams (QA, DevOps, UI/UX) to ensure successful project deliveries.
• Communicate effectively with stakeholders and project managers to provide regular status updates.

Project and Process Management:

• Participate in Agile/Scrum development processes, including sprint planning, daily stand-ups, and retrospectives.
• Ensure project timelines are met and escalate issues where necessary.
• Take ownership of assigned modules/components from design to production deployment.

Documentation and Technical Support:

• Create and maintain documentation for code, design, and architecture.
• Provide post-deployment technical support and resolve production issues.
• Troubleshoot Azure-related environment issues causing production outages.

Qualifications & Skills:

• Bachelor’s degree in Computer Science, Information Technology, or a related field
  (or equivalent practical experience)
• 3+ years of hands-on experience in software development
• Proven experience in developing and maintaining .NET-based web applications
• Experience working in Agile development environments
• Strong proficiency in C#, ASP.NET, MVC, and .NET Core
• Experience with SQL Server, database design, and performance optimization
• Knowledge of RESTful APIs and web services
• Experience with Git or other version control systems
• Understanding of Agile/Scrum methodologies
• Good problem-solving and debugging skills
• Strong communication and teamwork abilities

Location: Kochi (Work from office only)
Reports To: Product Manager
Job Type: Full-time (10 a.m. – 7:00 p.m. IST)

Job Summary:

The PHP Developer is responsible for developing, maintaining, and enhancing web applications using Laravel while creating responsive and user-friendly interfaces with modern frontend technologies. This role includes converting Figma designs into pixel-perfect HTML/CSS layouts, working with MySQL databases, integrating RESTful APIs, and ensuring clean, secure, and maintainable code following best practices. The developer utilizes Git for version control, supports application deployment (preferably on Azure), and troubleshoots issues to optimize application performance and reliability.

Key Responsibilities:

• Develop, maintain, and enhance web applications using Laravel; 

• Strong expertise in Laravel is required. 

• Build responsive UI components using HTML, CSS, JavaScript, and jQuery. 

• Convert Figma designs into pixel-perfect, responsive HTML/CSS layouts. 

• Convert Figma designs into reusable React components, ensuring design consistency and performance. 

• Design and manage MySQL databases, including schema design and query optimization. 

• Solid knowledge of MySQL is required. 

• Integrate backend services with frontend frameworks; knowledge of React is an added advantage. 

• Work with RESTful APIs and third-party integrations. 

• Deploy and maintain applications on Azure (preferred). 

• Experience Git and follow version control workflows. 

• Write clean, maintainable code following Laravel best practices. 

• Implement unit testing is preferable. 

• Troubleshoot bugs, optimize application performance, and enhance application security 

Qualifications & Skills:

• Bachelor’s degree in Computer Science, IT, or a related field (preferred).
• 3–4 years of experience as a PHP Developer.
• Strong proficiency in PHP and Laravel framework.
• Solid knowledge of MySQL database design, queries, and optimization.
• Experience with HTML, CSS, JavaScript, and jQuery for building responsive UI.
• Ability to convert Figma designs into pixel-perfect, responsive layouts.
• Understanding of RESTful APIs and third-party integrations.
• Familiarity with React is an added advantage.

Location: Kochi (Work from office only)
Reports To: Team Lead – Non-Clinical
Job Type: Full-time (6:30 p.m. – 3:30 a.m. IST)

Job Summary:

The Pre-Authorizations Specialist is responsible for managing referral intake and securing timely insurance authorizations for home health and hospice services. This role ensures accurate patient chart creation, verifies eligibility, and confirms patient qualification for services. The specialist coordinates with case managers, physicians, and patients to obtain required documentation, discharge information, and records necessary for authorization. Additionally, the position maintains detailed referral records, conducts welcome calls to validate patient information, and ensures all documentation is properly recorded to support smooth processes.

Key Responsibilities:

Referral Management:

• Monitor and maintain the Excel file containing referral information for home health and hospice patients.

Patient Chart Creation:

• Create and update patient charts in MatrixCare promptly and accurately.

Case Manager Follow-Up:

• Contact case managers to obtain discharge dates missing from referrals or orders.

Eligibility Verification:

• Check patient eligibility for home health and hospice services via insurance portals.
• Ensure that insurance coverage is in-network with the service provider and verify that the patient’s address is in Connecticut. If the address is not in Connecticut, consult with the patient regarding the possibility of changing it with their insurance provider and inform them of the 24-48 hour processing time.

Insurance Communication:

• Communicate any out-of-pocket costs to patients if their insurance meets eligibility criteria.
• Print and attach insurance eligibility and benefits documentation in the patient’s chart in the MatrixCare.

Physician Coordination:

• Call the primary care physician listed in the referral/order.
• If the physician declines to sign home health orders, inquire whether the patient has another physician who can authorize the orders.
• For cancer patients, confirm if the oncologist is willing to sign all necessary documents for the entire episode of care.

Welcome Call Duties:

• Confirm the patient’s address and phone number for scheduling the SOC (Start of Care) visit.
• Verify if the patient can sign documents independently.
• Assess the patient’s homebound status; if the patient is not homebound and has commercial or Medicare insurance, inform them that intake can only proceed if they have Medicaid coverage.
• For patients who can drive and perform daily activities, confirm that they do not meet homebound criteria and advise them to contact the private duty nursing department.
• If the patient cannot be accepted, notify the sales representative and the referral source.
• Document all information in MatrixCare after the welcome call.

Qualifications & Skills:

• Minimum of 1–3 years of experience in U.S. healthcare administration, intake, and authorizations (U.S. healthcare experience is mandatory)
• Experience in home health and/or hospice settings strongly preferred
• Prior experience working with insurance eligibility verification and authorizations within the U.S. healthcare system
• Familiarity with electronic medical records (EMR) systems used in U.S. healthcare settings
• Excellent verbal and written communication skills

Location: Kochi (Work from office only)
Reports To: Team Lead - RCM
Job Type: Full-time (6:30 p.m. – 3:30 a.m. IST)

Job Summary:

The AR & Denial Analyst is responsible for managing accounts receivable and analyzing denied claims to identify root causes, trends, and opportunities to improve overall revenue cycle performance. This role ensures timely follow-up on receivables and denied claims, and submits appeals and resubmissions in accordance with payer guidelines.

Key Responsibilities:

• Review and analyze denied claims to identify root causes and trends in claim rejections.   

• Collaborate with internal teams to develop and implement effective denial resolution strategies.   

• Ensure claims are reworked, appealed, and resubmitted by payer guidelines.   

• Perform root cause analysis to reduce future denials and educate the team on best practices.   

• Maintain knowledge of CPT, HCPCS, ICD-10 codes, payer policies, and medical terminology.   

• Track and report on denial rates, trends, and resolution status to support continuous improvement.   

• Maintain compliance with healthcare regulations, including HIPAA and payer-specific rules. 

Qualifications & Skills:

• 1–2 years of experience in Accounts Receivable (AR) within the US healthcare domain
• Strong communication, analytical, and problem-solving skills
• Hands-on experience with AR follow-up tools and medical billing software

CLINIQON IS HIRING FOR RCM TEAM LEAD!

The Team Lead – Home Health & Hospice Billing is responsible for overseeing the day-to-day billing operations, ensuring accurate and timely submission of claims, and guiding the billing team to meet productivity, quality, and compliance targets. This role requires strong knowledge of Home Health & Hospice billing regulations, NOA/NOE processes, payer-specific guidelines, and end-to-end RCM workflows. The Team Lead serves as the first level of escalation, ensures process adherence, and collaborates with QA, AR, Coding, and Clinical teams to resolve billing issues.

KEY RESPONSIBILITIES

• Assign daily tasks and monitor workload.
• Conduct team huddles and performance reviews.
• Oversee NOA/NOE, Final, and Hospice billing.
• Review claims for accuracy and completeness.
• Ensure proper use of EMR systems and clearinghouses.
• Ensure all billing follows payer and Medicare/Medicaid guidelines.
• Maintain SOPs and perform regular quality checks.
• Identify and address process issues.
• Handle escalations for claim errors and rejections.
• Coordinate with AR, Coding, Intake, and Clinical teams.
• Track submissions, rejections, timely filing and unbilled claims and report them immediately.
• Prepare and share performance reports.

REQUIRED SKILLS & QUALIFICATIONS

• Minimum 1–2 years of Home Health & Hospice billing experience (mandatory).
• Deep knowledge of:
• CMS regulations
• NOA/NOE processes
• Timely filing guidelines
• Proficiency in EMR platforms (e.g., Axxess, WellSky, Kinnser) and clearinghouses.
• Strong communication, team management, and problem-solving skills.
• Ability to analyze trends and generate operational insights.
• High attention to detail and process-oriented mindset.
• Ability to manage a high performing team of 15+ agents who work remotely in different time zones and geography.

Interested applicants may send their resume to:phcareers@cliniqon.com or jjavinal@cliniqon.com

Join our dynamic team and be part of something extraordinary.

CLINIQON IS LOOKING FOR HOME HEALTH CASE MANAGEMENT NURSES!

Key Responsibilities:

• Conduct timely and thorough SOC and ROC assessments in compliance with Medicare/Medicaid agency guidelines.
• Complete OASIS documentation accurately and withing required timeframes.
• Develop individualized patient care plans based on assessment findings, in collaboration with physicians and interdisciplinary team members.
• Coordinate and oversee the implementation of care plans, ensuring appropriate services are initiated.
• Communicate regularly with Physicians, and other healthcare professionals.
• Evaluate patient progress, revise care plans as necessary, and ensure continuity of care.
• Maintain detailed and timely clinical documentation in the EMR system.

Qualifications:

• Current active RN license.
• Minimum of 1-2 years experience as CM in Home Health.
• Strong understanding of OASIS documentation and CMS Regulations.
• Proven experience in conducting SOC and ROC assessments.
• Ability to work independently and manage time effectively.
• Strong communications and interpersonal skills.

Monday-Friday, 12 AM PHT - 9 AM PHT 

Intake Coordinator for home health services for managing the process of admitting new patients into a home health care. The role requires excellent organizational and communication skills, attention to detail, and a strong understanding of healthcare procedures and regulations.

• Review and evaluate patient referrals to determine eligibility for home health services.
• Schedule initial assessments and coordinate with healthcare professionals to plan patient care.
• Collect and verify patient information, insurance details, and medical records, ensuring all documentation is complete and accurate.
• Ensure that all intake procedures comply with regulatory requirements and organizational policies.
• Address any issues that arise during the intake process, such as insurance approvals or scheduling conflicts.

Qualifications:

• Registered Nurse (RN)
• Experience with MatrixCare
• In-depth knowledge of:
  • Private and government-funded insurance plans
  • Home health and hospice eligibility
  • Benefits verification (coinsurance, copay, deductible)
• Ability to read and interpret patient charts (H&P/HPI, diagnosis, medications)

System and Portal Experience:

• Referral Portals: Epic Yale, Epic Hartford, Epic UConn, Epic Middlesex, Navi, CarePort, Axxess, Kinnser, Home Health EMRs
• Other Systems: PCC, BambooHealth
• Insurance Portals: NGSConnex, CT DSS, Availity, UHC

Key Responsibilities:

• Assess home health and hospice referrals according to agency guidelines
• Determine palliative or hospice appropriateness
• Verify insurance coverage and benefits
• Obtain necessary clinical information prior to admission
• Create patient charts in the EMR and attach relevant clinical documentation
• Monitor patient discharge status and verify discharge paperwork
• Provide updates to the agency’s hospitalization and scheduling departments on patient status
• Handle inbound and outbound calls with patients, families, and healthcare providers
• Respond to emails and manage referrals received through portals

Communication and Collaboration:

• Build and maintain strong relationships with onshore agency staff, clinicians, and facility staff
• Effectively communicate with multidisciplinary teams to ensure smooth patient transitions

Skills:

• Strong verbal and written communication skills
• Ability to manage multiple tasks and prioritize effectively
• Attention to detail and problem-solving abilities

Position: Home Health Medical Coders
Location: Philippines- Remote
Shift: Morning shift

Qualifications:

• Minimum of 2 years experience in Home Health coding
• Experience with Plan of Care (POC) and OASIS Review
• Certified Professional Coder (CPC) certification required
• HCS-O or HCS-D certification is a plus
• Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems
• Excellent communication and collaboration skills
• Ability to work independently and within a team
• Must be available to start ASAP

Job Descriptions:

• Analyze patients’ charts carefully
• Utilize specialized medical classification software to assign diagnosis codes
• Assign codes to diagnoses using ICD-10-CM codes following the PDGM guidelines by CMS
• Enter coding information in an online program
• Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations
• Follow up with the provider on any documentation that is insufficient or unclear
• Communicate with other clinical staff regarding documentation
• Search for information in cases where the coding is complex or unusual
• Be updated about new coding rules as codes change from time to time
• Manage detailed, specifically coded information
• Maintain patient confidentiality and information security
• Ensure that all codes are current and active

Qualifications:
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar medical coding certification like HCS-D or HCS-O is required
• Expertise in ICD-10, OASIS, and CMS guidelines
• Minimum of 3-5 years of experience in medical coding, with at least 1-2 years in a leadership or supervisory role
• Proficiency in using medical coding software, EHR systems, and Microsoft Office Suite (Excel, Word, PowerPoint)
• Fluent in English, both written and spoken.
• Strong understanding of HIPAA compliance and confidentiality standards.
• Ability to work under pressure and handle sensitive situations with professionalism.
• Flexibility in working hours, including availability for overtime or weekend work as needed
Job Descriptions:
• Team Management & Leadership
• Quality Control & Reporting
• Client & Internal Communication
• Performance Monitoring & Issue Resolution
• Daily: Check team attendance, monitor work allocation, update trackers, and handle CREs and priority tasks.
• Weekly: Conduct team huddles, plot coaching sessions, monitor KPIs, attend relevant meetings, and report on team performance.
• Monthly: Submit MTD (Month-to-Date) performance reports, review and track team KPIs, and ensure all coding activities are logged and documented.