Companions embedded in the cavities of transitional circumstellar disks have been observed to exhibit excess luminosity at Hα, an indication that they are actively accreting. We report 5 yr (2013-2018) of monitoring of the position and Hα excess luminosity of the embedded, accreting low-mass stellar companion HD 142527 B from the MagAO/VisAO instrument. We use pyklip, a Python implementation of the Karhunen-Loeve Image Processing algorithm, to detect the companion. Using pyklip forward modeling, we constrain the relative astrometry to 1-2 mas precision and achieve sufficient photometric precision (±0.2 mag, 3% error) to detect changes in the Hα contrast of the companion over time. In order to accurately determine the relative astrometry of the companion, we conduct an astrometric calibration of the MagAO/VisAO camera against 20 yr of Keck/NIRC2 images of the Trapezium cluster. We demonstrate agreement of our VisAO astrometry with other published positions for HD 142527 B, and use orbitize! to generate a posterior distribution of orbits fit to the relative astrometry of HD 142527 B. Our data suggest that the companion is close to periastron passage, on an orbit significantly misaligned with respect to both the wide circumbinary disk and the recently observed inner disk encircling HD 142527 A. We translate observed Hα contrasts for HD 142527 B into mass accretion rate estimates on the order of 4-9 × 10-10 M yr-1. Photometric variation in the Hα excess of the companion suggests that the accretion rate onto the companion is variable. This work represents a significant step toward observing accretion-driven variability onto protoplanets, such as PDS 70 b