Overpayment Specialist 2

Inova Health; Fairfax (VA); Ibrido; USD 45.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental and vision coverage

Retirement match (5%)

Tuition and student loan assistance

Mental health support

Paid time off and parental leave

Flexible work schedules

Descrizione del lavoro

Inova Health seeks an Overpayment Specialist 2 in Fairfax, VA for a full-time day shift. The role involves researching overpayments, validating refund eligibility, and processing refunds per payer contracts, regulations, and policies. The Hybrid arrangement requires reporting on-site two times per week.

Minimum qualifications include a High School diploma or GED and 2 years of experience. EPIC experience is preferred; comprehensive benefits are offered.

Competenze

• High School diploma or GED is required.
• Minimum 2 years of experience in a related role.

Mansioni

• Reviews patient and insurance accounts with credit balances to identify the cause of overpayments and determine the appropriate resolution, including refunds, adjustments, or transfers.
• Processes patient and insurance refund requests accurately and within established turnaround times while ensuring compliance with organizational policies and applicable regulations.
• Researches payment discrepancies and coordination of benefits issues to ensure proper disposition of account credits.
• Verifies refund eligibility by reviewing payment history, EOBs, contractual obligations, and account documentation.
• Coordinates with departments and insurance carriers to resolve outstanding credit balances and refund inquiries.

Conoscenze

Attention to detail

Team collaboration

Communication

Formazione

High School or GED

Strumenti

EPIC

Descrizione del lavoro

Inova Health is looking for a dedicated Overpayment Specialist 2 to join the team. This role will be full-time day shift from Monday - Friday, 8:00 a.m. - 5:00 p.m. (Hybrid - Must Report On-Site Two Times per week) The Overpayment Specialist 2 is responsible for the timely and accurate resolution of patient and insurance credit balances by researching overpayments, validating refund eligibility, and processing refunds in accordance with payer contracts, federal and state regulations, and organizational policies. The Credit Specialist ensures compliance with refund requirements while maintaining accurate account documentation, collaborating with internal departments, and resolving credit balance discrepancies. This position takes ownership of identifying, researching, and resolving credit balances to minimize financial risk and ensure regulatory compliance.

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

Overpayment Specialist 2 Job Responsibilities

• Reviews patient and insurance accounts with credit balances to identify the cause of overpayments and determine the appropriate resolution, including refunds, adjustments, or transfers.
• Processes patient and insurance refund requests accurately and within established turnaround times while ensuring compliance with organizational policies, payer guidelines, and applicable federal and state regulations.
• Researches payment discrepancies, duplicate payments, coordination of benefits issues, and billing errors to ensure proper disposition of account credits.
• Verifies refund eligibility by reviewing payment history, explanation of benefits (EOBs), contractual obligations, and account documentation.
• Coordinates with Patient Financial Services, Revenue Cycle, Patient Access, Billing, Coding, Compliance, and insurance carriers to resolve outstanding credit balances and refund inquiries.

Minimum Qualifications

• Education: High School or GED
• Experience : 2 years of experience

Preferred Qualifications

• Experience accurately posting payments, adjustments, and denials in EPIC from electronic and manual remittance advices (ERAs/EOBs).
• Strong ability to review and research remittance advices to ensure proper payment application and resolve discrepancies.
• Proficiency in investigating and resolving unapplied or misapplied cash deposits in a timely manner.
• Experience reconciling daily deposits with bank statements and EPIC postings to ensure financial accuracy.
• Familiarity with month-end and year-end reconciliation processes.
• Ability to identify and escalation payment issues, trends, or system errors to management.