Revenue Integrity Analyst (Hybrid/Remote)

Inova Health; United States; Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Retirement 5% match

Tuition and student loan assistance

Mental health support sessions

Paid time off and parental leave

Flexible schedules and remote/hybrid机会

Job summary

Inova Health is seeking a dedicated Payment Integrity professional to join our team. This full-time, hybrid role requires working Monday through Friday with location options across VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV.

The ideal candidate will have 6 years of experience in payment integrity or denials management, with a strong background in analytics, reimbursement policies, and collaboration with operational leadership.

Qualifications

• 6 years of experience in Payment Integrity, Denials Management, or similar roles.
• Associate's degree in Finance, Business Administration, Healthcare Management or related field, or HS Diploma/GED with 2+ years relevant experience.

Responsibilities

• Validate reimbursement accuracy against payor agreements, fee schedules and payment policies.
• Analyze claims, remittances, contractual allowances and payment activity for variances.
• Investigate reimbursement issues due to contract misapplication, processing errors or policy changes.
• Monitor reimbursement trends and escalate recurring issues to leadership.
• Conduct reviews of claims, remittances, refunds and recoupments to identify overpayment recovery opportunities.
• Identify root causes of overpayments and recommend corrective actions.
• Perform root cause analyses to identify drivers of payment discrepancies, denials and risks.
• Translate reimbursement findings into actionable recommendations for operations and leadership.
• Support initiatives related to revenue protection and payment accuracy improvement.

Skills

Root cause analysis

Critical thinking

Verbal communication

Problem solving

Proactive work ethic

Education

Associate's degree in Finance/Business/Healthcare

HS Diploma or GED with experience

Tools

Excel (formulas)

Pivot tables

Epic reporting (SlicerDicer)

Job description

Inova Health is seeking a dedicated Payment Integrity professional to join our team. This full-time, hybrid role requires working Monday through Friday with location options across VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV.

The ideal candidate will have 6 years of experience in payment integrity or denials management, with a strong background in analytics, reimbursement policies, and collaboration with operational leadership.