Physician Insurance Analyst 4

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Retirement match

Education assistance

Student loan assistance

Mental health support

Job summary

Inova Health System is seeking a Physician Insurance Analyst to join our team in a full-time, hybrid role. The position emphasizes accurate claims editing, submission, and follow-up across all payer types, with a focus on productivity and quality standards.

The analyst will handle CPT/ICD-10 interpretations, payer portal navigation, and training for staff on these processes, while contributing to special projects related to claims and denials follow-up.

Qualifications

• Education required: High School or GED.
• 3 years Account Executive experience in revenue cycle operations, billing, cash posting.
• Experience with EPIC and payer portals.

Responsibilities

• Edit, submit, and follow up on assigned claims for all payer types with productivity and quality.
• Process appeals (levels 1 and 2) and check claim status via phone or payer website.
• Identify trends, analyze data, and escalate to the appropriate leader or teams.
• Ensure payer response, rejection, and denials reports are worked timely per standards.
• Interpret CPT, ICD-10, and APC reimbursements to maintain strong receivable performance.
• Train new team members on all payer portals and navigate systems.

Skills

Revenue cycle knowledge

Billing experience

Education

High School or GED

Tools

EPIC

Clearinghouse portals

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.

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:offeringup 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.

• 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.