Patient Financial Services Representative 4 - Customer Service (Bilingual)

Inova Health System; Virginia (IL); Hybrid; USD 48,000 - 60,000; Full time

Benefits offered by this job

Committed to Team Member Health

Retirement: Inova matches the first 5%

Tuition and Student Loan Assistance: $

Mental Health Support

Work/Life Balance

Job summary

Inova Health System is seeking a dedicated Patient Financial Services Representative 4 - Customer Service for the CALL CENTER. This full-time, day-shift role (Mon-Fri, 8:00am-4:00pm) is Hybrid with remote eligibility for several states.

You will edit, submit, and follow up on claims across multiple payer types, provide guidance to team members, and maintain documentation per quality standards; collaboration with departments and payers is essential.

Qualifications

• Associate degree or 3 years of relevant experience.
• At least 3 years in revenue cycle, finance, customer service, or data analytics.

Responsibilities

• Ensure clean claims are submitted the day received with attachments; act in supervisor’s absence.
• Resolve complex issues by coordinating with team members and payers; seek supervisor help when needed.
• Ensure claims are reviewed and corrected within 24 hours of receipt; support team efficiency.
• Handle high-dollar and complex accounts with appropriate follow-up.
• Document all account activity within 48 hours of receipt; maintain professional records.
• Document activity in HealthQuest and TRAC; ensure documentation is accurate and compliant.
• Work payer response and rejection reports; stay updated on payer requirements and UB-92 standards.
• Take direction from management and assist team; perform duties in supervisor’s absence.
• May perform additional duties as assigned.

Skills

Bilingual

Customer service

EPIC software

Remote work productivity

Communication

Revenue cycle experience

Education

Associate Degree

3 years of relevant experience

Tools

EPIC

HealthQuest

TRAC

Job description

Inova Health is looking for a dedicated Patient Financial Services Representative 4 - Customer Service to join the team in the CALL CENTER. This role will be full-time day shift from Monday - Friday, 8:00am-4:00pm, Hybrid

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

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.

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.

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

Patient Financial Services Representative 4 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.

Minimum Qualifications:

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

Preferred Qualifications:

• Bilingual (English and Spanish) strongly preferred to better support a diverse patient population.
• Deliver exceptional customer service by addressing patient inquiries with professionalism, empathy, and clear communication.
• Utilize EPIC to review, update, and maintain accurate patient account information.
• Support a positive patient experience by assisting 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 ensure timely resolution of billing issues.
• Demonstrate openness to feedback and continuously adapt to improve service quality and efficiency.
• Perform effectively in a remote work environment, maintaining productivity and accountability.