Physician Insurance Analyst 4

Inova Health; Fairfax (VA); Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health coverage

Retirement match

Education assistance

Mental health support

Flexible schedules

Job summary

Inova Health is seeking a dedicated Physician Insurance Analyst to join our team in a Full-Time, hybrid role. The position supports claims editing, submission, and denial follow-up across payer types using EPIC and payer portals.

The role emphasizes quality and productivity, training staff, and leading special projects related to claims and denials follow-up. This opportunity is based in Northern Virginia with a hybrid schedule.

Qualifications

• Education - High School or GED.
• Experience - 3 years Account Executive Experience in revenue cycle operations, billing, cash posting, and/or administrative support in physician billing.

Responsibilities

• Performs duties of Physician Insurance Analyst I–III and provides training to new staff or implements insurance updates.
• Responsible for timely and accurate editing, submission, and follow-up of assigned claims, meeting weekly productivity and quality standards.
• Processes claims for all payer types and handles EPIC charge reviews and claim edits to meet payer criteria.
• Manages Appeals (levels 1 and 2) and checks claim status via phone or payer websites.
• Identifies trends, analyzes data, and escalates trends to leaders/teams.
• Ensures payer response, rejection, and denial reports are worked timely per departmental standards.
• Interprets CPT, ICD-10, and APC reimbursements to support strong receivable performance.
• Trains new team members on all payer portals and navigates them through portals.
• Leads special projects related to claims and denials follow-up and may take on additional duties.

Education

High School diploma or GED

Job description

Job Description

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

Job Description

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.

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, flexible work schedules, and remote and hybrid career opportunities

Job 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.

Additional Requirements

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

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.