Revenue Integrity Analyst — Hybrid

Inova Health System; Fairfax (VA); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical, dental & vision

Retirement match

Education assistance

Student loan assistance

Mental health support

Remote & hybrid work

Paid time off

Job summary

Inova Health System is seeking a dedicated Payment Integrity professional for a full-time hybrid role. The position requires residing in eligible states to work remotely, including VA and several neighboring states.

You will validate reimbursements and analyze payment activities to identify variances and opportunities for recovery. The ideal candidate has 6+ years in Payment Integrity or related fields, with strong Excel and Epic HB reporting skills.

Qualifications

• Associate degree or equivalent plus 2 years of relevant experience; or HS diploma with relevant experience.
• 6 years of experience in Payment Integrity, Denials Management, or similar roles.
• Strong Excel skills and Epic reporting experience preferred.

Responsibilities

• Validates reimbursement accuracy against payor agreements, fee schedules, reimbursement methodologies, and payment policies.
• Analyzes claims, remittances, contractual allowances, and payment activity to identify payment variances and systemic discrepancies.
• Investigates reimbursement issues related to contract misapplication, processing errors, coding discrepancies, authorization requirements, or policy changes.
• Monitors reimbursement trends and escalates recurring issues requiring operational, contractual, or payor intervention.
• Conducts detailed reviews of claims, remittances, refunds, and recoupments to identify overpayment recovery opportunities.
• Determines root causes of overpayments and recommends corrective actions to prevent recurrence.
• Conducts root cause analyses to identify drivers of payment discrepancies, denials, and reimbursement risks.
• Translates complex reimbursement findings into actionable recommendations for operational teams and leadership.
• Supports strategic initiatives related to revenue protection, reimbursement optimization, and payment accuracy improvement.
• May perform additional duties as assigned.

Skills

Payment integrity

Denials management

Root cause analysis

Excel

Epic HB

Education

Associate degree in finance/healthcare

HS diploma/GED + 2 years experience

Tools

Epic HB

Pivot Tables

SlicerDicer

Job description

Inova Health System is seeking a dedicated Payment Integrity professional for a full-time hybrid role. The position requires residing in eligible states to work remotely, including VA and several neighboring states.

You will validate reimbursements and analyze payment activities to identify variances and opportunities for recovery. The ideal candidate has 6+ years in Payment Integrity or related fields, with strong Excel and Epic HB reporting skills.