Physician Insurance Analyst 4

InovaFairfax, VA
Hybrid

About The Position

Inova is looking for a dedicated Physician Insurance Analyst to join the team. This role will be Full-Time Monday through Friday Hybrid. 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

  • High School or GED
  • 3 years Account Executive Experience in Revenue cycle operations, billing, collections, cash posting, and/or administrative support in physician billing

Responsibilities

  • Performs the duties of a Physician Insurance Analyst 1, 2, and 3 and demonstrates leadership by providing training to new staff or deploying insurance updates to existing staff.
  • Responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims, while meeting the expected Productivity and Quality Standards on a weekly basis.
  • Processes claims for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.) and processes all types of EPIC charge reviews and claim edits.
  • Assure all assigned claims meet clearinghouse and/or payer processing criteria.
  • Processes Appeals (levels 1 and 2) and checks claim status via phone/payer website for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.).
  • Identifies trends and analyzes data, escalating trends to the appropriate leader/teams.
  • Ensures payer response reports and rejection/denials reports are worked timely and meet Departmental Productivity and Quality Review Standards.
  • Effectively interprets CPT, ICD-10, and APC reimbursements to ensure a strong receivable performance.
  • Demonstrates ability to effectively use and navigate all payer portals, and effectively trains new team members on all payer portals.
  • Works on special projects related to claims and denials follow-up.
  • Leads special projects related to claims and denials follow-up, and may perform other 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
  • remote and hybrid career opportunities
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