Revenue Integrity Analyst — Hybrid/Remote Eligible

Inova Health System; Virginia; Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health coverage

Retirement match

Education assistance

Student loan assistance

Mental health support

Paid time off & parental leave

Job summary

Inova Health System is seeking a dedicated Payment Integrity professional to join our team. This full-time, hybrid role requires location within designated states and offers a path to advance reimbursement expertise within a leading national healthcare system.

The ideal candidate will analyze claims and provider reimbursements, identify discrepancies, and implement corrective actions to protect revenue. Strong communication and problem-solving skills are essential for success in this role.

Qualifications

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

Responsibilities

• Validates reimbursement accuracy against payor agreements and policies.
• Analyzes claims, remittances, allowances, and payment activity for variances.
• Investigates reimbursement issues due to contract, coding, or policy changes.
• Monitors reimbursement trends and escalates recurring issues.
• Reviews claims, remittances, refunds to identify overpayment opportunities.
• Determines root causes of overpayments and recommends corrective actions.
• Performs root cause analyses of payment discrepancies and denial risks.
• Translates findings into actionable recommendations for teams and leadership.
• Supports initiatives related to revenue protection and payment accuracy improvement.
• May perform additional duties as assigned.

Skills

Denials management

Reimbursement analysis

Root cause analysis

Communication

Education

Associate's degree in Finance/Healthcare

HS Diploma/GED + 2 years experience

Tools

Epic reporting tools

Excel (Pivot Tables)

SlicerDicer

Job description

Inova Health System is seeking a dedicated Payment Integrity professional to join our team. This full-time, hybrid role requires location within designated states and offers a path to advance reimbursement expertise within a leading national healthcare system.

The ideal candidate will analyze claims and provider reimbursements, identify discrepancies, and implement corrective actions to protect revenue. Strong communication and problem-solving skills are essential for success in this role.