The Patient Account Specialist is responsible for performing duties in the billing division pertaining to all aspects of the revenue cycle, which includes but is not limited to extracting and updating appropriate CPT and ICD-10 codes, data entry, denials, patient account research, and insurance follow-up. The position will also play a key role in the daily entry of inpatient and outpatient charges for the Department of Obstetrics and Gynecology which includes Maternal Fetal Medicine, General Obstetrics and Gynecology, Urogynecology and Minimally Invasive Gynecological Surgery.

This position is responsible for assisting with physician and staff education based upon EVMS Medical Group Compliance Guidelines, coding guidelines and results of chart audits in conjunction with the Billing Manager. The position will assist with conducting internal departmental mini-audits to ensure inpatient and outpatient medical records contain sufficient documentation to justify the frequency and type of services being billed to carriers and patients.

• Enter inpatient and outpatient charges adhering to carrier regulations.
• Research and assign the appropriate CPT & ICD10 code based on the provider’s dictation, and other medical records to ensure that the most accurate combination of codes is used for each patient.
• Audit and review the appropriateness of the CPT and ICD10 coding selections, assuring that the appropriate link between the two coding procedures has occurred.

• Work closely with providers to ensure notes are submitted in a timely manner for claims processing.

• Follow up with providers on missing Information when the documentation provided does not support the services rendered.
• Respond to denials provided by EVMS Medical Group.

• Review tasks in the EHR daily.

• Maintain close relations with hospital staff and referring offices, reaching out to obtain required documentation as needed.
• Authorize procedures and verify benefits with appropriate insurance company.

• Must possess the ability and skills to work independently in a team environment.

• Maintain compliance with Policies and Procedures within the Department of Generalist OB/GYN, Minimally Invasive and Gynecologic Surgery, Urogynecology and Maternal Fetal Medicine.
• Assist with conducting regular coding education and training classes for providers and staff in conjunction with the Billing Manager.
• Make recommendations on implementing procedures for compliance within the department setting.
• Provides feedback to management as to problem areas and when proper information cannot be obtained from providers.
• Responsible for staying abreast of insurance carrier regulation changes and informing providers, management, and staff of such changes.
• Ongoing review of compliance, coding, and billing, literature and guidelines effecting OBGYN practices.
• Functions as liaison between the providers and EVMS Medical Group Billing Office to communicate and/or educate regarding the appropriate use of the procedural and diagnostic coding process.
• Performs other duties as assigned.

Associates degree plus at least one (1) year experience working with CPT & ICD 10 coding in a surgical setting required. Prior experience with OBGYN coding and billing strongly preferred. Current CPC certification or ability to obtain certification within one year of employment, required.