
10,000+ employees
Founded 2017
âď¸ Healthcare Insurance
đ Transport
đ° $525M Post-IPO Debt on 2024-07
Healthcare Insurance ⢠Transport
Modivcare is a company that focuses on simplifying the experience of living with complex healthcare needs by providing a comprehensive suite of supportive care solutions. They specialize in non-emergency medical transportation, personal care, and virtual & remote patient monitoring. Modivcare works closely with Medicaid Plans, State Agencies, Medicare Advantage, SNP Plans, health systems, healthcare professionals, and transportation providers, ensuring that members receive necessary health services. Through innovative technology and data-driven strategies, they address social determinants of health by offering services like quality transportation, chronic care management, meal delivery, and in-home assistance, aimed at optimizing patients' health outcomes and improving their overall experience.
đĽ 0 minutes ago
đşđ¸ United States â Remote
đľ $17 / hour
â° Full Time
đĄ Mid-level
đ Senior
đ Billing Specialist
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10,000+ employees
Founded 2017
âď¸ Healthcare Insurance
đ Transport
đ° $525M Post-IPO Debt on 2024-07
Healthcare Insurance ⢠Transport
Modivcare is a company that focuses on simplifying the experience of living with complex healthcare needs by providing a comprehensive suite of supportive care solutions. They specialize in non-emergency medical transportation, personal care, and virtual & remote patient monitoring. Modivcare works closely with Medicaid Plans, State Agencies, Medicare Advantage, SNP Plans, health systems, healthcare professionals, and transportation providers, ensuring that members receive necessary health services. Through innovative technology and data-driven strategies, they address social determinants of health by offering services like quality transportation, chronic care management, meal delivery, and in-home assistance, aimed at optimizing patients' health outcomes and improving their overall experience.
⢠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 ⢠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.
⢠High School Diploma required ⢠Zero (0) 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 ⢠Effective problem-solving and negotiation skills ⢠Ability to handle confidential and sensitive information with discretion ⢠Exceptional organizational and time management abilities ⢠Familiarity with HIPAA regulations and compliance.
⢠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!)
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