EVMS Patient Account Representative in Norfolk, Virginia

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

Billing Functions

  • 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.

High School graduate with at least one-year experience in a Health Care billing and collections environment. Knowledge of Third Party Payer rules and regulations. Knowledge of CPT and ICD9 coding practices. A minimum of 45 WPM typing ability. Good interpersonal skills. Appreciation for confidentiality.


Position Number: 6409499

External Company Name: Eastern Virginia Medical School

External Company URL: www.evms.edu