Patient Account Representative
Eastern Virginia Medical School
Overview Performs all phases of Third Party Billing and Follow-up on services provided by EVMS Medical Group clinical staff. Responsibilities
Location : Location US-VA-Norfolk
- 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.
Location : Location US-VA-Norfolk
Vacancy posted 2 days ago
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