Inova Health is looking for a dedicated Patient Financial Services
Representative 4 - Technical Denials team. This role will be full-time day shift
from Monday - Friday, 8:00am - 5:00pm, Remote Role
Remote Eligibility: This position is eligible for remote work for candidates
residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN,
TX, WV
Inova is consistently ranked a national healthcare leader in safety, quality and
patient experience. We are also proud to be consistently recognized as a top
employer in both the D.C. metro area and the nation.
Featured Benefits:
Committed to Team Member Health: offering medical, dental and vision
coverage, and a robust team member wellness program.
Retirement: Inova matches the first 5% of eligible contributions – starting
on your first day.
Tuition and Student Loan Assistance: offering up to $5,250 per year in
education assistance and up to $10,000 for student loans.
Mental Health Support: offering all Inova team members, their
spouses/partners, and their children 25 mental health coaching or therapy
sessions, per person, per year, at no cost.
Work/Life Balance: offering paid time off, paid parental leave, and flexible
work schedules
Patient Financial Services Representative 4 Job Responsibilities:
Ensures that all clean claims are submitted the day they are received,
submitted via the appropriate medium, and with all required attachments.
Serves in the place of the supervisor or manager in their absence.
Resolves complex issues either through individual actions or by coordinating
information/actions of other team members, Patient Accounts staff, other
hospital departments, or at the payer level. Seeks assistance from supervisor
when needed.
Ensures that claims are reviewed, corrections are identified/made or
resolutions are initiated within 24 hours from the date that claims are
received. Identifies the need for and provides support/guidance to other team
members to promote their efficiency and productivity.
Handles complex and/or highest dollar accounts while providing appropriate
follow-up based on established protocol or SRGs.
Ensures appropriate and timely documentation of all account activity while
appropriately handling all correspondence within 48 hours of receipt.
Documents activity in HealthQuest and TRAC and ensures that documentation is
professional, appropriate, accurately depicts actions performed, and is in
accordance with departmental quality review standards.
Works payer response reports and rejection reports while ensuring they meet
departmental productivity and quality review standards. Maintains knowledge
of payer requirements, UB-92 standards, system (Hospital, clearinghouse,
payer) functionality, and hospital policies and procedures.
Takes direction from management to resolve issues in addition to providing
support, education, and guidance to team members. Performs duties, as
assigned, in the absence of the supervisor or manager.
May perform additional duties as assigned.
Minimum Qualifications:
Education: Associate Degree or an additional three years of experience
appropriate to the position under consideration
Experience: 3 years of Experience in revenue cycle, finance, customer
service or data analytics
Preferred Qualifications:
Expertise in Insurance Follow-Up Resolutions highly preferred.
Proficiency in hospital billing systems (e.g., Epic) and insurance
verification portals.
Insurance & Compliance Knowledge: Extensive understanding of Medicaid,
Medicare, commercial insurance, and self-pay policies. Familiarity with HIPAA
regulations and hospital financial assistance programs.
Analytical & Problem-Solving Skills: Ability to analyze patient accounts,
identify discrepancies, and resolve billing or insurance issues effectively.
Preference for candidates in the Northern Virginia, District of Columbia and
Maryland area
We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Every
day, our 26,000+ team members provide world-class healthcare to the communities
we serve. Our people are the reason we're a national leader in healthcare
safety, quality and patient experience. And from best-in-class facilities to
professional development opportunities, we support them at every step. At Inova,
we're constantly striving to be ever better — to shape a more compassionate
future for healthcare.
Inova Health is an Equal Opportunity employer. All qualified applicants will
receive consideration for employment without regard to age, color, disability,
gender identity or expression, marital status, national or ethnic origin,
political affiliation, pregnancy (including childbirth, pregnancy-related
conditions and lactation), race, religion, sex, sexual orientation, veteran
status, genetic information, or any other characteristics protected by law.