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.

1. VISIT PLOTTING & RECONCILIATION
   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.

2. BILLING READINESS & PREPARATION
   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.

3. AUTHORIZATION & UNIT VERIFICATION
   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.

4. EVV RECONCILIATION
   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.

5. DOCUMENTATION REVIEW
   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.

• Place affected services on the Billing Hold Report until corrected.

6. BILLING HOLD MANAGEMENT
   Maintain a current Billing Hold Report containing: Patient | DOS | Payer | Service | Units/Charges | Reason for Hold | Responsible
   Person | Date Identified | Follow-Up Date | Status.

• Hold categories may include documentation, signature, authorization, EVV, eligibility, scheduling discrepancy, coding, missing order,

incorrect units, payer issue or clinical review.

• Open billing holds must be reviewed and followed up on daily.
• Aged or unresolved items must be escalated to the Office Manager.

7. BILLING HANDOFF
   Prepare organized billing batches according to the established billing schedule. Clearly separate READY TO BILL from DO NOT BILL
   / ON HOLD.
   Communicate unusual payer requirements, corrections or known issues to the biller before claim submission.
   The Billing & Visit Reconciliation Coordinator is accountable for the accuracy and completeness of billing preparation. The Biller
   remains responsible for claim creation/submission, clearinghouse processing, rejection correction, denial management, payment
   Billing & Visit Reconciliation Coordinator - Job Description Page 3
   posting and A/R follow-up unless otherwise assigned.