EVMS

Patient Account Representative

Position Number
6409411
Department
EVMS Medical Group
Category
Administrative/Clerical
Compensation Max
USD $16.25/Hr.
Compensation Min
USD $12.50/Hr.
US-VA-Norfolk

Overview

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

Responsibilities

  • Responsible for the electronic and manual billing to Third Party Payers in a timely, proficient fashion and maintaining the Gateway system.
  • Review all manual claim forms for accuracy prior to the claim submission.
  • Understand the required attachments to claims, as they relate to CPT, ICD9, and modifier coding practices.  Reviews claims for appropriate documentation attachments.
  • Ensure that all carrier requirements are supported with claims submitted.
  • Communicate with the EVMS Health Services 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.

 

Insurance Follow-up functions:

  • Responsible for the timely follow-up, account research, and resolution of outstanding Third Party claims.
  • Maintain an IDX paperless collection system (PCS) workfile, as assigned by the Insurance Department Supervisor.
  • Utilize the PCS tickler system to follow through on the carrier’s promise to pay claims.
  • Identify and have corrections made to any CPT/ICD9/Modifer coding error that prohibits the claim(s) from the final adjudication process.
  • Coordinate the exchange of insurance information with the EVMS Health Services 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 and/or tracers 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.

Qualifications

HS diploma or GED and one year experience in healtcare billing required.  Must have experience with ICD-9 and CPT coding and strong customer service skills.

Location : Location

US-VA-Norfolk

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