C

Claim Health

AI-powered post-acute billing optimization

Clinical Quality Assurance Nurse

Full-Time
No salary listed
Mid
New York, NY, USA
In Person
QA & TestingManual & Functional QA

About the job

Requirements
  • An active Registered Nurse license is required; a New York or compact license is preferred.
  • At least 3 years of home health and/or hospice clinical experience is required.
  • Strong understanding of OASIS documentation and home health eligibility requirements is required.
  • Experience reviewing physician orders, certifications, plans of care, face-to-face documentation, and hospice election paperwork is required.
  • Hands-on experience with HomeCare HomeBase, Axxess, and WellSky is required; KanTime is a plus.
  • Strong understanding of Medicare home health and hospice documentation requirements is required.
  • Experience writing standard operating procedures, quality assurance guidelines, or training documentation is required.
  • Strong attention to detail and pattern recognition are required.
  • Comfort working in a fast-paced startup environment is required.
Responsibilities
  • Review charts processed by the clinical automation platform for accuracy, completeness, and consistency; validate whether documentation supports services, identify incorrect classifications, and investigate automation errors.
  • Partner with engineering and product teams to refine how artificial intelligence evaluates clinical documentation; identify missed clinical nuances, recommend decision rules, and validate improvements before deployment.
  • Develop standard operating procedures defining how clinical documentation should be reviewed across home health and hospice, standardizing quality expectations while accounting for agency-specific workflows and payer requirements.
  • Work directly with agencies to understand their documentation standards, clinical workflows, and compliance expectations, and help configure automations to align with client processes.
  • Measure and improve documentation quality, automation accuracy, exception rates, clinical escalations, and rework, while identifying opportunities to improve automation performance.
Desired Qualifications
  • QA, Clinical Documentation Integrity, or compliance experience.
  • Experience with artificial intelligence, workflow automation, or healthcare technology companies.
  • Familiarity with referral platforms including Careport and Forcura.
  • Experience implementing or optimizing electronic medical record workflows.

About the company

Claim Health offers an AI-powered platform for revenue cycle management in post-acute care. It uses an AI rules engine to automatically generate and submit compliant claims, with 24/7 expert support, a compliance engine, and advanced analytics. The solution targets post-acute care providers, demonstrating a high first-pass acceptance rate and a rise in appealed denials through continuous analytics and support. Its goal is to help financial leaders reclaim lost revenue, shrink denial rates, and improve overall financial performance to let providers devote more resources to patient care.

Company Size

11-50

Company Stage

Seed

Total Funding

$4.5M

Headquarters

New York City, New York

Founded

2025

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Simplify's Take

What believers are saying

  • January 21, 2026 seed funding added Peak XV, Y Combinator, and operator angels.
  • Early customers Ascend Health, Interim HealthCare, and Home Care RN validate demand.
  • Claim Health reported 30x revenue growth after YC and 50% admin workload reduction.

What critics are saying

  • Medusind, FinThrive, and Rivet crowd post-acute revenue cycle workflows with deeper distribution.
  • Eleven employees as of June 2026 limits implementation capacity against enterprise buyers.
  • If authorization automation misses payer changes, denials and customer churn follow quickly.

What makes Claim Health unique

  • January 2026 product spans referral-to-reimbursement, not isolated claims scrubbing.
  • Claim Health centralizes fax, email, and portal referrals inside provider EMRs.
  • Y Combinator Spring 2025 backing and Maverick-led seed signal strong founder-market fit.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Unlimited Paid Time Off

Company Equity

Performance Bonus

Growth & Insights and Company News

Headcount

6 month growth

33%

1 year growth

33%

2 year growth

50%
FinSMEs
Jan 22nd, 2026
Claim Health Raises $4.4M in Seed Funding

Claim Health raises $4.4M in Seed funding. Claim Health, a NYC-based company empowering AI-native revenue operations for post-acute care, raised $4.4M in Seed funding. The round was led by Maverick Ventures, with participation from Peak XV, Y Combinator, and DHVP. It also included C-suite executives. including CEOs and COOs, at large post-acute care providers. Led by CEO Kevin Calcado, Claim Health provides an AI-powered revenue platform that manages the referral-to-reimbursement workflow, including intake, eligibility verification, authorization management, and payment reconciliation, without manual portals or paperwork. By automating and coordinating these workflows, it enables providers to reduce administrative burden and revenue leakage. Early customers include Ascend Health, Interim HealthCare, and Home Care RN.

Business Wire
Jan 22nd, 2026
Claim Health Launches AI-Powered Revenue Infrastructure for Post-Acute Care with $4.4M Seed Funding

Claim Health, the company powering AI-native revenue operations for post-acute care, today announced a $4.4 million Seed round led by Maverick Ventures, with...