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 and engaging in effective communication with payers, clients, and other stakeholders.
Resolves problems by clarifying issues, researching potential solutions, helping to implement changes to maximize timely and complete reimbursement, and escalating unresolved issues.
Coordinates and understands specific data such as modifiers, payer specific information, including authorization criteria, CPT/HCPCS and ICD-10 coding.
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.
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 Electronic Visit Verifications (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.
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.
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.
Participate in other projects or duties as assigned.
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 lbs.
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 applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.
