Patient Account Representative

Eastern Virginia Medical School • Norfolk, VA

107d • Onsite

About The Position

Performs all phases of Third Party Billing and Follow-up on services provided by EVMS Medical Group clinical staff.

Requirements

• High School diploma/GED
• Basic computer and keyboarding skills
• Ability to communicate ideas clearly
• Ability to follow written processes and procedures
• Ability to maintain composure in stressful situations

Nice To Haves

• Prior medical billing experience

Responsibilities

• Responsible for the electronic and manual billing to Third Party Payers in a timely, proficient fashion and maintaining the PayerPath system.
• Review all manual claim forms for accuracy prior to the claim submission.
• Understand the required attachments to claims, as they relate to CPT,ICD10 and modifier coding practices. Reviews claims for appropriate documentation attachments.
• Ensure that all carrier requirements are supported with claims submitted.
• Communicate with the EVMS Medical Group clinical departments, hospitals, and patients to secure insurance data and/or medical documentation required to file claims.
• Operate the Touchworks Scan filing system to retrieve required documentation, referrals, and/or other pertinent data to file claims.
• Review IDX claim edit lists to make the necessary corrections to data input errors or missing information.
• Post the “insurance billed” paycode to all manual filed claims.
• Post the “Appeal Sent” paycode to all appealed claims.
• Responsible for the timely follow-up, account research, and resolution of outstanding Third Party claims.
• Maintain an ETM work-file, as assigned by the Insurance Department Supervisor.
• Utilize the ETM tickler system to follow through on the carrier’s promise to pay claims.
• Identify and have corrections made to any CPT/ICD10/Modifier coding error that prohibits the claim(s) from the final adjudication process.
• Coordinate the exchange of insurance information with the EVMS Medical Group clinical departments to expedite claim processing.
• Identify appropriate adjustments to patient accounts for submission to the Senior PAR or the Insurance Department Supervisor.
• Prepare insurance claim forms on unpaid invoices in a timely fashion.
• Handle incoming calls from the insurance carriers and respond to their requests in a timely fashion.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED