Patient Account Representative

EVMS Medical Group; Norfolk (VA); On-site; USD 42,000 - 54,000; Full time

Job summary

EVMS Medical Group seeks a Billing Specialist to manage patient accounts, verify insurance, obtain authorizations, and follow up on denials to support timely reimbursement. The role collaborates with clinical and scheduling staff to address authorization requirements, document billing activities, and communicate with patients about estimated financial responsibility before procedures.

Experience in revenue cycle and knowledge of payer requirements is preferred.

Qualifications

• At least 1 year of patient billing, insurance verification, authorization, patient accounts, or revenue cycle experience preferred.
• Experience with medical billing and insurance processes preferred.
• Knowledge of commercial insurance, Medicare, Medicaid, Tricare, and other payer requirements preferred.
• Experience researching and resolving insurance denials and claim-related issues preferred.

Responsibilities

• Determine whether insurance authorization or referral requirements apply to scheduled services.
• Obtain, initiate, or facilitate insurance authorizations when appropriate.
• Identify incorrect authorization information and coordinate with payers and offices to correct discrepancies.
• Follow up on pending authorizations and referrals to avoid delays in scheduling and care.
• Follow up with insurance carriers and self-pay accounts to resolve issues.
• Maintain accurate and timely documentation of billing and insurance follow-up activities.
• Assist patients with questions regarding insurance coverage, balances, deductibles, and coinsurance.
• Communicate estimated financial responsibility to patients prior to service dates.
• Provide patients with estimated out-of-pocket costs for elective procedures when available.
• Coordinate with scheduling and clinical staff to ensure financial clearance for elective cases.

Skills

Insurance verification

Authorization management

Billing & collections

Patient communication

Job description

Perform duties within the billing and revenue cycle functions related to all aspects of patient account management, insurance verification, authorization requirements, billing, denials, patient interaction, account research, and insurance follow-up.

This position is responsible for supporting accurate and timely reimbursement by identifying and resolving insurance, authorization, demographic, coding and billing issues. The position works collaboratively with clinical staff, scheduling staff, referral coordinator, providers, patients, referring offices, and insurance payers to facilitate patient access, reduce delays, prevent avoidable claim denials, and support the financial health of the department.

• Determine whether insurance authorization or referral requirements apply to scheduled services.
• Obtain, initiate, or facilitate insurance authorizations when appropriate and within departmental scope.
• Identify incorrect or incomplete authorization information and work with referring offices, payers, and internal departments to correct discrepancies.
• Follow up on pending authorizations and referrals to prevent unnecessary delays in patient scheduling and care.
• Follow-up with insurance carriers (unpaid, denied, or delayed claims) and self-pay accounts.
• Maintain accurate and timely documentation of billing and insurance follow-up activities.
• Assist patients with questions regarding insurance coverage, authorizations, balances, deductibles, and coinsurance.
• Communicate directly with patients regarding their estimated financial responsibility for elective procedures and services prior to the scheduled date of service.
• Provide patients with estimated out-of-pocket costs for elective cases when information is available and in accordance with organizational policies.
• Coordinate with scheduling, clinical staff, and other appropriate departments to ensure financial clearance requirements for elective cases are addressed prior to the date of service.

Preferred Qualifications

• Minimum of one year of patient billing, insurance verification, authorization, patient accounts, or revenue cycle experience preferred.
• Experience with medical billing and insurance processes.
• Knowledge of commercial insurance, Medicare, Medicaid, Tricare, and other payer requirements preferred.
• Experience with insurance authorization and referral requirements preferred
• Experience researching and resolving insurance denials and claim-related issues preferred.

US-VA-Norfolk