Revenue Cycle Coordinator

ModivCare Solutions; United States; Remote; USD 20,000 - 26,000; Full time

Job summary

ModivCare Solutions in the United States is seeking a Billing Specialist to ensure timely and accurate payment for services, manage accounts receivable, verify insurance coverage, and support communication with payers and clients.

The role collaborates with the Revenue Cycle team, EVV, and compliance initiatives while handling inquiries and resolving disputes to facilitate reimbursements and maintain data integrity.

Qualifications

• High School diploma required.
• 0+ 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 and ICD-10.
• Proficiency in using electronic billing systems and software.
• HIPAA/compliance knowledge.

Responsibilities

• Monitors and manages accounts receivable, ensuring timely collection of payments.
• Reviews outstanding balances and resolves delinquent invoices.
• Uses electronic billing systems to track payments and generate reports.
• Collaborates with billing team to ensure accurate claim submissions.
• Verifies client insurance coverage and eligibility.
• Maintains updated insurance records and data accuracy.
• Supports Revenue Cycle Management activities including EVV and billing.
• Responds to billing inquiries and resolves disputes with payers.
• Audits and updates billing codes and processes for compliance.
• Communicates changes and provides system updates to the team.

Skills

Attention to detail

Communication skills

Problem solving

Time management

HIPAA familiarity

Education

High School diploma

Tools

Electronic billing systems

Job description

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!

This position is responsible for ensuring timely and accurate payment for services rendered, managing accounts receivable, verifying insurance coverage, and engaging in effective communication with payers, clients, and other stakeholders.

Responsibilities

• Monitors and manages accounts receivable, ensuring the timely collection of payments for services provided.
• Reviews and analyzes outstanding accounts, identifying delinquent or unpaid invoices, and taking appropriate actions to resolve outstanding balances.
• Utilizes electronic billing systems and software to track and update payment information, maintain accurate billing records, and generate reports as needed.
• Collaborates with the billing team to ensure accurate and complete claim submissions, resolving any billing discrepancies or errors.
• Verifies insurance coverage for clients, confirming eligibility, benefits, and any pre-authorization requirements.
• Maintains updated records of insurance information, ensuring accuracy and completeness.
• Supports the Revenue Cycle Management team with all efforts related to Revenue Cycle and billing, collections, and EVV.
• Adapts to changes in work responsibilities as required with changing and shifting priorities and focus.
• Monitors rejections from portals to ensure billing reprocessing is identified timely, including EVV where necessary.
• Works as a liaison between the internal billing team, Central Operations and authorizations to correct errors and verify service.
• Provides system updates, weekly audits and data entry support to correct errors so that the completed visits are eligible for billing.
• Monitors AR related to service authorizations to ensure payment.
• Troubleshoots any problems, concerns, difficulties with the system and communicates to Supervisor or Manager.
• Follows SOX compliance within systems as outlined.
• Watches for potential fraud to reduce incorrect billing.
• Audits and validates all billing functions.
• Updates and cross checks all billing procedure codes in the system.
• Maintains and grows skillset in various tools utilized for billing.
• Provides subject matter expertise in all systems utilized in the Revenue Cycle to aid in learning and process improvement.
• Responds to billing inquiries from clients, insurance companies, and other relevant parties, addressing concerns, providing explanations, and resolving disputes in a timely manner.
• Investigates and resolves billing discrepancies or claim denials, working closely with payers and the billing team to facilitate appropriate reimbursement.
• Prepares regular reports on accounts receivable status, aging analysis, and collection efforts, presenting findings to the management team.
• Maintains organized and accurate documentation of all collection activities, including communication logs, payment arrangements, and collections correspondence.
• Stays up to date with relevant insurance regulations, billing guidelines, and industry changes, ensuring compliance with all applicable laws and regulations.
• Adheres to privacy and confidentiality policies when handling sensitive financial and personal information.
• Establishes and maintains positive and professional relationships with clients, insurance companies, and other stakeholders involved in the payment process.
• Communicates with clients regarding their financial responsibilities, payment options, and any outstanding balances.
• Participates in other projects or duties as assigned.

Qualifications

• High School diploma required
• Zero (0) plus years of experience.
• Or equivalent combination of education and/or experience.
• Familiarity with insurance verifiation, authorization, and claims submission processes.
• Proficient knowledge of medical billing codes, including CPT and ICD-10.
• Proficiency in using electronic billing systems and software.
• Excellent attention to detail and accuracy.
• Effective problem-solving and negotiation skills.
• Strong written and verbal communication skills.
• Ability to handle confidential and sensitive information with discretion.
• Exceptional organizational and time management abilities.
• Familiarity with HIPAA regulations and compliance.

Salary: $14.23 - $19.21

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of the position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job.

Primarily seated work; extensive computer and telephone use; occasional standing, walking, reaching, bending, and lifting up to 10 lb s.

Modivcare's positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of