Patient Account Specialist Job at Eastern Virginia Medical School
Overview:
Location : Location: US-VA-Norfolk
Perform duties to support the EVMS Radiation Oncology departments at Sentara Norfolk General Hospital (SNGH), Sentara Virginia Beach General Hospital (SVBGH), and Sentara Obici Hospital (SOH) related to all aspects of the revenue cycle to include denials, patient interaction, patient account research, insurance follow-up, faculty assistance, and administrative duties. This position requires usage of patient electronic health record using IDX, Allscripts/Touchworks system, and Sentara software systems (Mosaiq/Aria/Epic).
Responsibilities:
- Responsible for incoming documentation via fax and retrieving EVMS Radiation Oncology mail from mail room twice a week and distributing mail to designated/appropriate physician and office personnel.
- Responsible for printing all patient information, to include insurance, patient identification, demographic information, involvement of care form, and EVMS registration form utilizing the Sentara software system database (Mosaiq/Aria) in accordance with the patient appointment logs.
- Responsible for creating and labeling patient charts and ensuring information obtained is properly registered in the IDX system, run patient eligibility, and scanned into the EVMG (Medical Group) scan database for SVBGH, SNGH, and SOH within 24 to 48 hours of the patient’s date of service. Communicate with Sentara stall for any missing information need for EVMG registration.
- Assist with the requests for disability determination and other insurance related matters as required. Serve as a liaison with EVMG, Sentara clinical staff and other administrative staff within EVMS.
- Research and resolve insurance denials utilizing the IDX Task System and email request from Medical Group (EVMG) representatives.
- Review patient documentation utilizing the assigned tasks in the IDX Task System for review of patient encounters, including diagnostic and procedural information, to research and analyze documentation needs for EVMG claims appeal reimbursement.
- Review and verify the documentation supports the diagnoses, procedures and treatment results. Audits clinical documentation and add CPT codes to the documentation being submitted for validating services billed for EVMG claims appeal reimbursement.
- Audits documentation and compliance requirements utilizing insurance guidelines and standardization of industry practices for EVMG claims appeal reimbursements and accurate electronic health record and electronic treatment record.
- Analyzes medical records and identifies documentation deficiencies, billing discrepancies, and recommends review by supervisor for direction to correct discrepancies. Completes approved error corrections to correct billing errors and/or for EVMG claims appeal reimbursement.
- Update patient demographics, insurance, run eligibility in IDX, and notify EVMG for billing new patient insurance or for EVMG claims appeal reimbursement.
- Assists patients with insurance information, including benefits, claims processing, insurance and patient balances. Processes patient payment within the department and discuss payment options and contact information for payment plans to assist with patient remaining balances. Process and submit cash receipt payments for processing as required by EVMG Cash Receipts Policy and Procedures.
- Assists patients with obtain claims records for filing third party companies for patient payouts (AFLAC).
- Obtain “inpatient” status CHKD patients authorizations for radiation oncology treatment by calling insurance carrier authorization department prior to the start of patient treatment.
- Process and distribute physician Tumor Boards by agenda suppling patient records that will be reviewed by the physicians in the tumor board meetings.
- Must possess the ability and skill to independently work in a team environment. Handles special projects as requested and/or performs other duties as assigned.
Associates degree plus one (1) year experience working with CPT & ICD 10 coding and billing required. Current CPC certification, or must obtain within 1 year of employment required.
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