Billing Coordinator II

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. Responsibilities Resolve problems by clarifying issues, researching potential solutions, and helping to implement changes to maximize timely and complete reimbursement, and escalating unresolved issues. Coordinate and understand specific data such as modifiers, payer specific information, including authorization criteria, CPT/HCPCS and ICD-10 coding. Monitor and manage accounts receivable, ensuring timely collection of payments for services provided; review and analyze outstanding accounts, identify delinquent or unpaid invoices, and take appropriate actions to resolve outstanding balances. Utilize electronic billing systems and software to track and update payment information, maintain accurate billing records, and generate reports as needed. Collaborate with the billing team to ensure accurate and complete claim submissions, resolving any billing discrepancies or errors. Maintain updated records of insurance information, ensuring accuracy and completeness. Support the Revenue Cycle Management team with all efforts related to revenue cycle and billing, collections, and Electronic Visit Verifications (EVV). Adapt to changes in work responsibilities as required with changing and shifting priorities and focus. Monitor rejections from portals to ensure billing reprocessing is identified timely, including EVV where necessary. Work as a liaison between the internal billing team, Central Operations and authorizations to correct errors and verify service. Provide system updates, weekly audits and data entry support to correct errors so that the completed visits are eligible for billing. Monitor AR related to service authorizations to ensure payment. Troubleshoot any problems, concerns, difficulties with the system and communicate to Supervisor or Manager. Follow SOX compliance within systems as outlined. Watch for potential fraud to reduce incorrect billing. Audit and validate all billing functions. Provide subject matter expertise in all systems utilized in the Revenue Cycle to aid in learning and process improvement. Respond to billing inquiries from clients, insurance companies, and other relevant parties, addressing concerns, providing explanations, and resolving disputes in a timely manner. Investigate and resolve billing discrepancies or claim denials, working closely with payers and the billing team to facilitate appropriate reimbursement. Maintain organized and accurate documentation of all collection activities, including communication logs, payment arrangements, and collections correspondence. Stay up to date with relevant insurance regulations, billing guidelines, and industry changes, ensuring compliance with all applicable laws and regulations. Adhere to privacy and confidentiality policies when handling sensitive financial and personal information. Establish and maintain positive and professional relationships with clients, insurance companies, and other stakeholders involved in the payment process. Communicate with clients regarding their financial responsibilities, payment options, and any outstanding balances. Participate in other projects or duties as assigned. Qualifications High School Diploma required; preferred one (1) plus years of experience or equivalent combination of education and/or 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. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Regularly required to sit and use hands to finger, handle, or feel. Required to stand, walk and reach with hands and arms. Occasionally lift and/or move up to 10 pounds. Specific vision abilities required include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. 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!) Equal Opportunity Employer Modivcare is an Equal Opportunity Employer. EEO is The Law – Modivcare is an Equal Opportunity Employer. Minorities/Women/Protected Veterans/Disabled. We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. #J-18808-Ljbffr ModivCare Solutions, LLC