Job Overview
Location
Remote
Job Type
Full-time
Category
Software Engineering
Date Posted
June 23, 2026
Full Job Description
đź“‹ Description
- • Verify client eligibility for services and document insurance verification prior to billing payers.
- • Submit monthly claims and invoices accurately via EDI, portal, and paper methods to ensure timely payment.
- • Research and resolve denied or rejected claims by analyzing EOBs, using payer portals, and contacting insurance companies and government payors.
- • Correct and update patient demographics, charges, adjustments, and payments, or escalate to appropriate departments when necessary.
- • Apply payer-specific data including modifiers, authorization criteria, CPT, and ICD-10 coding to claims.
- • Utilize multiple web portals and billing systems to access eligibility information and complete billing tasks.
- • Manage the full revenue cycle from charge creation through resolution of outstanding accounts receivable.
- • Work assigned rejection and denial workgroups to review, correct, and resubmit EDI claims promptly.
- • Respond to incoming phone calls using company phone system, addressing inquiries and providing billing support.
- • Complete reporting cards and tickets assigned through internal company applications.
- • Identify and document payer issues and communicate findings to RCM leadership.
- • Maintain KPIs and quality standards for billing accuracy and timeliness.
- • Perform resubmission projects and generate daily reports as required.
- • Participate in additional projects or duties as assigned.
- • Occasional business travel may be required.
🎯 Requirements
- • High School Diploma required
- • One (1) plus years of experience in healthcare revenue cycle management or a related field
- • Knowledge of portal, invoice, and EDI billing methods
- • Proficient in the use of Word, Excel, Outlook, and PowerPoint
- • Excellent verbal and written communication skills
- • Attention to detail and accuracy in all tasks
🏖️ Benefits
- • Medical, Dental, and Vision insurance
- • Employer Paid Basic Life Insurance and AD&D
- • 401(k) Retirement Savings Plan with Company Match
- • Paid Time Off
- • Paid Parental Leave
- • Tuition Reimbursement
Skills & Technologies
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About Modivcare Inc.
Modivcare Inc. provides non-emergency medical transportation, personal care, remote patient monitoring, and nutritional meal delivery services across the United States. It partners with state Medicaid programs, health plans, and managed care organizations to coordinate access to care for underserved and complex populations. Through technology-enabled logistics and a national network of transportation and care providers, the company aims to reduce healthcare costs and improve outcomes by addressing social determinants of health such as mobility, nutrition, and chronic disease management.
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