Full job description
Bilingual Billing & Care Coordination Specialist

Position Summary

The Bilingual Billing & Care Coordination Specialist is responsible for coordinating patient Supervised Visits (SVs) and assessments while ensuring timely and accurate billing for services provided. This position plays a critical role in maintaining billing accuracy, scheduling compliance, reconciliation of payroll and billing records, and communication between patients, Personal Care Workers (PCWs), Registered Nurses (RNs), and insurance payers. The ideal candidate is highly organized, detail-oriented, and capable of managing multiple priorities in a fast-paced healthcare environment.

Essential Responsibilities Billing Administration

● Prepare, review, and verify employee timesheets for billing accuracy.

● Scan and submit timesheets to designated third-party billing vendors within required submission deadlines

. ● Bill insurance claims for approved timesheets and Supervised Visits (SVs).

● Maintain accurate records of all timesheets received, submitted, and billed, including weekly billable hours by payer.

● Enter billing information into the Billing Spreadsheet and maintain accurate weekly tracking.

● Maintain and update the Master Billing Spreadsheet to ensure current billing records.

● Upload and track timesheets and missed punch forms for Electronic Visit Verification (EVV) processing while meeting the required 24-hour or 72-hour submission requirements based on payer guidelines.

● Reconcile payroll records with billing submissions to ensure billing accuracy.

● Assist with payment posting and remittance processing as assigned

● Review payroll journals with Human Resources to verify billable hours.

● Monitor Accounts Receivable (AR) and assist with collections and outstanding balances.

● Identify billing discrepancies, pending claims, and rejected claims, and communicate findings to management.

● Assist with reconciliation of billing records and remittance reports to ensure accurate reimbursement

. ● Prepare billing reports and other operational reports as requested

● Perform additional billing and administrative duties as assigned.

Care Coordination & Scheduling

● Coordinate with patients, Personal Care Workers (PCWs), and Registered Nurses (RNs) to schedule Supervised Visits (SVs) and assessments.

● Schedule all Supervised Visits according to the SV Tracking Sheet and all assessments requested by the Processing Department within 14 calendar days of the scheduling request.

● Meet scheduling Key Performance Indicators (KPIs) by:

○ Scheduling all Supervised Visits due within the next 30 days according to their due dates. ○ Scheduling all assessment requests within 14 calendar days of receipt.

● Reschedule appointments while identifying the best available option for the patient, PCW, and RN.

● Resolve scheduling conflicts promptly to prevent interruptions in patient care.

● Maintain and update the Supervised Visit (SV) Tracker within designated company databases, including Monday.com and Alora.

● Update Personal Care Worker (PCW) training records in Monday.com.

● Add, monitor, and update Supervised Visit (SV) holds within Monday.com and Alora.

● Maintain regular communication with Registered Nurses regarding scheduling availability.

● Attend weekly HOLDS meetings and provide scheduling updates.

● Ensure all scheduling documentation is accurate, complete, and compliant with agency policies and HIPAA regulations. Note: Supervised Visits (SVs) require both the client and the assigned Personal Care Worker (PCW) to be present in the client's home while being evaluated by a Tenderness Registered Nurse.