Patient Financial Services Representative 4 Technical Denials

Inova • Fairfax, VA

2d • Remote

About The Position

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.

Requirements

• Associate Degree or an additional three years of experience appropriate to the position under consideration
• 3 years of Experience in revenue cycle, finance, customer service or data analytics

Nice To Haves

• Expertise in Insurance Follow-Up Resolutions highly preferred.
• Proficiency in hospital billing systems (e.g., Epic) and insurance verification portals.
• Extensive understanding of Medicaid, Medicare, commercial insurance, and self-pay policies.
• Familiarity with HIPAA regulations and hospital financial assistance programs.
• 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

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.

Benefits

• medical, dental and vision coverage
• a robust team member wellness program
• Inova matches the first 5% of eligible contributions – starting on your first day.
• up to $5,250 per year in education assistance
• up to $10,000 for student loans
• 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• paid time off
• paid parental leave
• flexible work schedules

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree