Patient Financial Services Representative 4 - Customer Service (Bilingual)

Inova Health System•VA, VA

2d•$23 - $37•Hybrid

About The Position

Inova Health is hiring a full-time Patient Financial Services Representative 4 for its Customer Service team. The role is a hybrid, day-shift position, Monday through Friday, from 8:00 a.m. to 4:30 p.m. Remote work is available to candidates residing in VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, or WV. The representative performs the duties of a Patient Financial Services Representative 3 and is responsible for timely, accurate editing, submission, and follow-up of assigned claims across multiple payer types, including commercial, managed care, Blue Cross, Medicare, and Medicaid. The representative ensures claims meet clearinghouse and payer processing criteria and that work lists are followed up appropriately while meeting departmental productivity and quality standards. The role also identifies claims-process issues and potential resolutions, supports and guides team members, and may perform supervisory or managerial duties when the supervisor or manager is absent. Inova is a nonprofit healthcare provider with more than 26,000 team members. It describes itself as a national leader in healthcare safety, quality, and patient experience, and offers professional development opportunities.

Requirements

Associate degree, or an additional three years of experience appropriate to the position.
At least three years of experience in revenue cycle, finance, customer service, or data analytics.

Nice To Haves

Bilingual in English and Spanish is strongly preferred.
Ability to deliver exceptional customer service with professionalism, empathy, and clear communication.
Experience utilizing EPIC to review, update, and maintain patient account information.
Ability to assist patients with billing questions, insurance coverage, and financial responsibilities.
Ability to review and interpret Explanation of Benefits (EOBs) to resolve patient or insurance discrepancies.
Ability to collaborate with insurance providers to verify coverage, process claims, and ensure timely resolution of billing issues.
Openness to feedback and a willingness to adapt to improve service quality and efficiency.
Ability to perform effectively in a remote work environment while maintaining productivity and accountability.

Responsibilities

Submit clean claims on the day they are received, through the appropriate medium and with all required attachments.
Serve in place of the supervisor or manager during their absence.
Resolve complex issues independently or by coordinating information and actions among team members, Patient Accounts staff, hospital departments, and payers; seek supervisor assistance when needed.
Review claims and identify or make corrections, or initiate resolutions, within 24 hours of receipt.
Identify when team members need support or guidance and provide it to promote efficiency and productivity.
Handle complex and/or highest-dollar accounts and provide follow-up according to established protocol or SRGs.
Document account activity promptly and handle correspondence within 48 hours of receipt.
Record activity in HealthQuest and TRAC, ensuring documentation is professional, appropriate, accurate, and compliant with departmental quality standards.
Work payer response and rejection reports in accordance with departmental productivity and quality standards.
Maintain knowledge of payer requirements, UB-92 standards, hospital, clearinghouse, and payer system functionality, and hospital policies and procedures.
Take direction from management to resolve issues and provide support, education, and guidance to team members.
Perform additional duties as assigned.
Address patient inquiries professionally, empathetically, and clearly.
Use EPIC to review, update, and maintain patient account information.
Assist patients with billing questions, insurance coverage, and financial responsibilities.
Review and interpret Explanation of Benefits (EOBs) to resolve patient or insurance discrepancies.
Collaborate with insurance providers to verify coverage, process claims, and resolve billing issues in a timely manner.

Benefits

Medical, dental, and vision coverage.
Team member wellness program.
Retirement plan with a match on the first 5% of eligible contributions, starting on the first day.
Education assistance of up to $5,250 per year.
Student loan assistance of up to $10,000.
Up to 25 mental health coaching or therapy sessions per person, per year, at no cost, for team members, spouses or partners, and children.
Paid time off.
Paid parental leave.
Flexible work schedules.
Professional development opportunities.