Billing Assistant/EVV Coordinator

Ideal Home Health Agency•Pittsburgh, PA

16h•Onsite

About The Position

The Billing Assistant / EVV Coordinator is responsible for ensuring the accuracy, compliance, and timely completion of Electronic Visit Verification (EVV), scheduling oversight, insurance eligibility verification, and billing functions. This position supports agency operations by monitoring visit documentation, maintaining payor compliance requirements, processing billing submissions, and assisting with administrative functions necessary to ensure uninterrupted patient services and revenue cycle management.

Requirements

High school diploma or equivalent required.
Minimum one (1) year of experience in healthcare billing, EVV coordination, scheduling, administrative support, or related healthcare operations preferred.
Working knowledge of Medicaid, Managed Care Organizations (MCOs), EVV requirements, and healthcare billing processes preferred.
Strong organizational, analytical, and problem-solving skills.
Proficiency in Microsoft Office applications, including Excel, Outlook, and Word.
Ability to manage multiple priorities and meet strict deadlines.
Satisfactory professional references.
Satisfactory criminal background check and applicable clearances.
Ability to maintain confidentiality and comply with HIPAA requirements.
Ability to sit for extended periods while performing computer-based work.
Ability to occasionally lift office materials weighing up to 20 pounds.

Nice To Haves

Associate degree in Healthcare Administration, Business Administration, Accounting, or related field preferred.
Experience with HHAeXchange, Alora Plus, Availity, NaviNet, or similar healthcare systems.
Familiarity with Pennsylvania Medicaid home care billing requirements.
Experience working with managed care organizations including UPMC, AmeriHealth, Highmark Wholecare, and Health Partners Plans.
Ability to analyze billing discrepancies and resolve claim issues independently.
Bilingual in Nepali and/or Spanish preferred.

Responsibilities

Monitor patient schedules to ensure services align with authorized hours and approved Plans of Care.
Verify that all scheduled visits are completed, documented, and appropriately billed.
Identify scheduling discrepancies and coordinate corrective actions with appropriate departments.
Monitor the EVV call dashboard throughout the workday and address visit exceptions promptly.
Review EVV records daily for missed clock-ins, clock-outs, documentation issues, and visit discrepancies.
Communicate with caregivers, patients, and supervisors to resolve EVV exceptions.
Maintain a minimum quarterly EVV compliance rate of 90% or greater, or as required by payer contracts and agency standards.
Review and clear all prebilling items within established deadlines.
Complete prebilling review and prepare billing for services rendered from the 1st through the 15th by the first business day following the 15th of each month.
Complete prebilling review and prepare billing for services rendered from the 16th through the end of the month by the first business day of the following month.
Submit accurate and timely claims through HHAeXchange, Availity, and other payer-required billing platforms.
Ensure all billing submissions comply with payer guidelines and agency requirements.
Maintain billing logs and tracking reports by payer source.
Reconcile claims, remittance advice, and Explanation of Benefits (EOBs).
Research claim denials, payment discrepancies, and billing errors and initiate corrective actions or rebilling as necessary.
Assist with reporting and revenue tracking activities.
Allocate incoming payments to appropriate agency bank accounts based on remittance documentation and internal procedures.
Prepare and submit all required missed shift reports accurately and within payer deadlines.
Submit UPMC and Highmark missed shift reports monthly by the 10th day of the following month.
Submit AmeriHealth and Health Partners Plan missed shift reports weekly every Tuesday.
Maintain documentation supporting all reported missed visits.
Conduct insurance eligibility verification for all active patients every Monday or Tuesday when Monday falls on a holiday.
Perform monthly eligibility verification on the first business day of each month.
Notify appropriate staff, patients, and family members of any eligibility changes, coverage issues, or payer updates.
Maintain documentation of eligibility verification activities.
Enter newly hired employees into HHAeXchange, Alora, and other agency systems as assigned.
Maintain employee demographic and status information in agency software systems.
Assist with system updates and data maintenance as needed.
Provide support to Billing, Scheduling, Intake, Human Resources, Nursing, and Administrative departments as assigned.
Complete special projects and additional duties within required deadlines.
Participate in process improvement initiatives to improve efficiency and compliance.