Billing & Visit Reconciliation Coordinator

POSITION SUMMARY

The Billing & Visit Reconciliation Coordinator is responsible for ensuring that all completed patient/client visits are accurately plotted, reconciled, verified and prepared for billing. This position serves as the critical link between scheduling, clinical operations, authorization, EVV and billing. The Coordinator identifies and resolves discrepancies before claims are released to the biller. Every valid service provided must be identified, documented, authorized, reconciled and prepared for billing accurately and timely.

The Coordinator owns the billing-readiness process and helps prevent revenue loss caused by missing visits, incomplete documentation, EVV discrepancies, authorization problems, incorrect units or incomplete billing information. This position prepares services for billing but is not primarily responsible for claim submission, payment posting, denial management or accounts receivable follow-up.

Accurately plot/post completed visits into the appropriate EMR or billing system and reconcile the complete service workflow:
Scheduled Visit ->
Completed Visit -> EVV ->
Clinical Documentation ->
Authorization ->
Billing

• Review the previous day's completed visits each business day.
• Identify missing or unposted visits, missed visits, duplicate visits, incorrect dates of service, incorrect visit times, incorrect units and incorrect service codes.
• Identify visits appearing in EVV but not the EMR, visits appearing in the EMR without corresponding EVV, and visits without required documentation.
• Immediately communicate discrepancies to the appropriate department or responsible employee.

Prepare all eligible visits for billing. Before releasing a service to the biller, verify:

• Correct patient/client, payer, date of service and service type.
• Correct HCPCS, revenue or service code when applicable.
• Correct units and valid authorization when required.
• Available authorization units and required EVV verification.
• Required clinical documentation and signatures.
• Correct provider/clinician and no unresolved billing hold.
• Only clean, supported and billing-ready services are released to the biller.

Verify services against the applicable authorization before billing preparation.

• Monitor authorization effective and expiration dates.
• Verify approved service, frequency, units/hours, units utilized and units remaining.
• Immediately identify services that exceed or do not match an authorization.
• Communicate discrepancies to the Intake/Authorization/Scheduling team and Office Manager.
• Do not knowingly release unauthorized services for billing.

Reconcile EVV information against scheduled and completed services when EVV is required.

• Identify missing clock-in/clock-out, incorrect service times, incorrect attendant/provider, incorrect service code and incorrect member.
• Identify missing EVV records, EVV exceptions, manual adjustments requiring supporting documentation and visits failing EVV validation.
• Work with scheduling and appropriate staff to resolve EVV discrepancies before billing.
• Maintain appropriate supporting documentation for allowable EVV corrections.

Verify required documentation is present before services are released for billing. The Coordinator does not determine clinical appropriateness but must identify missing or incomplete documentation that prevents billing.

• Missing or unsigned visit notes.
• Incomplete documentation.
• Missing supervisory documentation when required.
• Missing orders/supporting documents.
• Documentation that does not match the billed service, date or EVV.

Maintain a current Billing Hold Report containing:
Patient | DOS | Payer |…