EVMS

  • Patient Account Representative

    Position Number
    6409458
    Department
    EVMS Medical Group
    Category
    Administrative/Clerical
    Compensation Max
    USD $16.58/Hr.
    Compensation Min
    USD $12.75/Hr.
    Location : Location
    US-VA-Norfolk
  • Overview

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

     

    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 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 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

    High school diploma or GED and minimum of one year of patient billing experience.  Experience in ICD-9/CPT coding is required.  Customer service oriented individual is required.

    Location : Location

    US-VA-Norfolk

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