Billing Coordinator II

Modivcare•Remote, PA, PA

3d•$16 - $22•Onsite

About The Position

This position is responsible for ensuring timely and accurate payment for services rendered, managing accounts receivable and engaging in effective communication with payers, clients, and other stakeholders. This role resolves problems by clarifying issues, researching potential solutions, helping to implement changes to maximize timely and complete reimbursement, and escalating unresolved issues. It coordinates and understands specific data such as modifiers, payer specific information, including authorization criteria, CPT/HCPCS and ICD-10 coding. The role monitors and manages accounts receivable, ensuring the timely collection of payments for services provided. It reviews and analyzes outstanding accounts, identifying delinquent or unpaid invoices, and taking appropriate actions to resolve outstanding balances. The Billing Coordinator II utilizes electronic billing systems and software to track and update payment information, maintain accurate billing records, and generate reports as needed. They collaborate with the billing team to ensure accurate and complete claim submissions, resolving any billing discrepancies or errors. This role maintains updated records of insurance information, ensuring accuracy and completeness. It supports the Revenue Cycle Management team with all efforts related to Revenue Cycle and billing, collections, and Electronic Visit Verifications (EVV). The Billing Coordinator II adapts to changes in work responsibilities as required with changing and shifting priorities and focus. They monitor rejections from portals to ensure billing reprocessing is identified timely, including EVV where necessary. This role works as a liaison between the internal billing team, Central Operations and authorizations to correct errors and verify service. It provides system updates, weekly audits and data entry support to correct errors so that the completed visits are eligible for billing. The Billing Coordinator II monitors AR related to service authorizations to ensure payment. They troubleshoot any problems, concerns, difficulties with the system and communicates to Supervisor or Manager. This role follows SOX compliance within systems as outlined. It watches for potential fraud to reduce incorrect billing and audits and validates all billing functions. The Billing Coordinator II maintains and grows skillset in various tools utilized for billing and provides subject matter expertise in all systems utilized in the Revenue Cycle to aid in learning and process improvement. They respond to billing inquiries from clients, insurance companies, and other relevant parties, addressing concerns, providing explanations, and resolving disputes in a timely manner. This role investigates and resolves billing discrepancies or claim denials, working closely with payers and the billing team to facilitate appropriate reimbursement. It maintains organized and accurate documentation of all collection activities, including communication logs, payment arrangements, and collections correspondence. The Billing Coordinator II stays up to date with relevant insurance regulations, billing guidelines, and industry changes, ensuring compliance with all applicable laws and regulations. They adhere to privacy and confidentiality policies when handling sensitive financial and personal information. This role establishes and maintains positive and professional relationships with clients, insurance companies, and other stakeholders involved in the payment process. It communicates with clients regarding their financial responsibilities, payment options, and any outstanding balances. The Billing Coordinator II will participate in other projects or duties as assigned.

Requirements

High School Diploma required
One (1) plus years of experience
Familiarity with insurance verification, authorization, and claims submission processes
Proficient knowledge of medical billing codes, including CPT/HCPCS and ICD-10
Proficiency in using electronic billing systems and software
Excellent attention to detail and accuracy
Equivalent combination of education and/or experience

Responsibilities

Ensuring timely and accurate payment for services rendered
Managing accounts receivable
Engaging in effective communication with payers, clients, and other stakeholders
Resolving problems by clarifying issues, researching potential solutions, helping to implement changes to maximize timely and complete reimbursement, and escalating unresolved issues
Coordinating and understanding specific data such as modifiers, payer specific information, including authorization criteria, CPT/HCPCS and ICD-10 coding
Monitoring and managing accounts receivable, ensuring the timely collection of payments for services provided
Reviewing and analyzing outstanding accounts, identifying delinquent or unpaid invoices, and taking appropriate actions to resolve outstanding balances
Utilizing electronic billing systems and software to track and update payment information, maintain accurate billing records, and generate reports as needed
Collaborating with the billing team to ensure accurate and complete claim submissions, resolving any billing discrepancies or errors
Maintaining updated records of insurance information, ensuring accuracy and completeness
Supporting the Revenue Cycle Management team with all efforts related to Revenue Cycle and billing, collections, and Electronic Visit Verifications (EVV)
Adapting to changes in work responsibilities as required with changing and shifting priorities and focus
Monitoring rejections from portals to ensure billing reprocessing is identified timely, including EVV where necessary
Working as a liaison between the internal billing team, Central Operations and authorizations to correct errors and verify service
Providing system updates, weekly audits and data entry support to correct errors so that the completed visits are eligible for billing
Monitoring AR related to service authorizations to ensure payment
Troubleshooting any problems, concerns, difficulties with the system and communicates to Supervisor or Manager
Following SOX compliance within systems as outlined
Watching for potential fraud to reduce incorrect billing
Auditing and validating all billing functions
Maintaining and growing skillset in various tools utilized for billing
Providing subject matter expertise in all systems utilized in the Revenue Cycle to aid in learning and process improvement
Responding to billing inquiries from clients, insurance companies, and other relevant parties, addressing concerns, providing explanations, and resolving disputes in a timely manner
Investigating and resolving billing discrepancies or claim denials, working closely with payers and the billing team to facilitate appropriate reimbursement
Maintaining organized and accurate documentation of all collection activities, including communication logs, payment arrangements, and collections correspondence
Staying up to date with relevant insurance regulations, billing guidelines, and industry changes, ensuring compliance with all applicable laws and regulations
Adhering to privacy and confidentiality policies when handling sensitive financial and personal information
Establishing and maintaining positive and professional relationships with clients, insurance companies, and other stakeholders involved in the payment process
Communicating with clients regarding their financial responsibilities, payment options, and any outstanding balances
Participating in other projects or duties as assigned

Benefits

Medical, Dental, and Vision insurance
Employer Paid Basic Life Insurance and AD&D
Voluntary Life Insurance (Employee/Spouse/Child)
Health Care and Dependent Care Flexible Spending Accounts
Pre-Tax and Post --Tax Commuter and Parking Benefits
401(k) Retirement Savings Plan with Company Match
Paid Time Off
Paid Parental Leave
Short-Term and Long-Term Disability
Tuition Reimbursement
Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)