Patient Financial Services Representative 4 (Bilingual)

DVS V3; Fairfax (VA); In loco; USD 55.000 - 75.000; Tempo pieno

Descrizione del lavoro

Inova in Fairfax, VA is seeking a bilingual Patient Financial Services Representative 4 to manage end-to-end claims editing, submission, and follow-up across multiple payer types. You will support the team, advise on denial resolutions, and ensure timely processing with documentation in HealthQuest and TRAC.

The role requires 3 years in revenue cycle/finance or data analytics, and an Associate Degree or equivalent experience. Equal opportunity employer.

Competenze

• 3 years of experience in revenue cycle, finance, customer service, or data analytics.
• Associate Degree or an additional three years of experience appropriate to the position.
• Certification - Not required; Licensure - Not required.

Mansioni

• Ensures clean claims are submitted the day received with all attachments.
• Resolves complex issues by coordinating with team members and payers.
• Ensures claims are reviewed within 24 hours of receipt and provides guidance to teammates.
• Handles high-dollar accounts with appropriate follow-up per protocol.
• Documents all account activity within 48 hours and maintains professional records.

Conoscenze

Revenue cycle

Customer service

Data analytics

Finance

Formazione

Associate Degree

Relevant experience (3 years)

Descrizione del lavoro

Patient Financial Services Representative 4 (Bilingual)

VA, United States

Job Description

The Patient Financial Services Representative 4 performs the duties of a Patient Financial Services Representative 3 and is responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims. Processes claim for multiple payer types (i.e. Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.) and ensures that all assigned claims meet clearinghouse and/or payer processing criteria. Ensures appropriate follow-up on assigned work lists while meeting all departmental productivity and quality review standards. Informs management of issues and potential resolutions regarding problems with the claims process. Provides support, education, and guidance to team members while performing duties, as assigned, in the absence of the supervisor or manager.
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.

Additional Requirements
Certification - Not requiredLicensure - Not requiredExperience - 3 years of Experience in revenue cycle, finance, customer service or data analyticsEducation - Associate Degree or an additional three years of experience appropriate to the position under consideration.

About Us

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.

Job Info

• Job Category Finance
• Locations Inova 8095 - Fairfax East