Revenue Integrity & Payment Accuracy Analyst

Inova Health; Virginia (MN); Hybrid; USD 80,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Retirement match

Education assistance

Mental health support

Paid time off & flexible schedules

Job summary

Inova is seeking a dedicated Payment Integrity professional to join our team. This full-time, Monday–Friday hybrid role focuses on ensuring accurate reimbursements and preventing denials across payer contracts and policies.

Located for work in VA/MD/DC regions, the ideal candidate has extensive experience in payment integrity and hospital billing, with strong analytical and problem-solving skills to support revenue protection initiatives.

Qualifications

• 6 years of experience in Payment Integrity, Denials Management, or similar roles.
• Hospital/healthcare billing knowledge is required.

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.

Education

Associate's degree in Finance, Business Administration, Healthcare Management

HS Diploma/GED with 2 years relevant professional experience

Tools

Epic HB

SlicerDicer

Job description

Inova is seeking a dedicated Payment Integrity professional to join our team. This full-time, Monday–Friday hybrid role focuses on ensuring accurate reimbursements and preventing denials across payer contracts and policies.

Located for work in VA/MD/DC regions, the ideal candidate has extensive experience in payment integrity and hospital billing, with strong analytical and problem-solving skills to support revenue protection initiatives.