Inova Health · 2 days ago
Patient Financial Services Representative 4 - Medicare Claims
United States
Full-time
Remote
Mid Level
3+ years expInova Health is looking for a dedicated Patient Financial Services Representative 4 - Medicare Claims to join the team. This role involves the timely and accurate editing, submission, and follow-up of assigned claims, ensuring compliance with processing criteria across multiple payer types.
GeneticsHealth CareMedical
Responsibilities
Ensures that all clean claims are submitted the day they are received, submitted via the appropriate medium, and with all required attachments. Serves in the place of the supervisor or manager in their absence
Resolves complex issues either through individual actions or by coordinating information/actions of other team members, Patient Accounts staff, other hospital departments, or at the payer level. Seeks assistance from supervisor when needed
Ensures that claims are reviewed, corrections are identified/made or resolutions are initiated within 24 hours from the date that claims are received. Identifies the need for and provides support/guidance to other team members to promote their efficiency and productivity
Handles complex and/or highest dollar accounts while providing appropriate follow-up based on established protocol or SRGs
Ensures appropriate and timely documentation of all account activity while appropriately handling all correspondence within 48 hours of receipt
Documents activity in HealthQuest and TRAC and ensures that documentation is professional, appropriate, accurately depicts actions performed, and is in accordance with departmental quality review standards
Works payer response reports and rejection reports while ensuring they meet departmental productivity and quality review standards. Maintains knowledge of payer requirements, UB-92 standards, system (Hospital, clearinghouse, payer) functionality, and hospital policies and procedures
Takes direction from management to resolve issues in addition to providing support, education, and guidance to team members. Performs duties, as assigned, in the absence of the supervisor or manager
May perform additional duties as assigned
Qualification
Required
Associate Degree or an additional three years of experience appropriate to the position under consideration
3 years of Experience in revenue cycle, finance, customer service or data analytics
Preferred
Utilize EPIC to review, update, and maintain accurate patient account information, including hospital billing accounts and Medicare billing workflows
Review and interpret EOBs and Medicare remittance advice to identify and resolve patient or insurance discrepancies (e.g., denials, underpayments, COB)
Collaborate with insurance providers (Commercial/Managed Care, Medicare, Medicaid) to verify coverage, process claims, and complete hospital billing follow-up to ensure timely resolution of billing issues
Demonstrate openness to feedback and continuously adapt to improve service quality, efficiency, and follow-up outcomes
Perform effectively in a remote environment while maintaining productivity, accuracy, and accountability in billing and follow-up work
Benefits
Offering medical, dental and vision coverage, and a robust team member wellness program.
Inova matches the first 5% of eligible contributions – starting on your first day.
Offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
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.
Offering paid time off, paid parental leave, and flexible work schedules
Company
Inova Health
We are Inova, Northern Virginia and the Washington, D.C. metropolitan area’s leading nonprofit healthcare provider.
10001+ employees
H1B Sponsorship
Inova Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (21)
2024 (16)
2023 (17)
2022 (7)
2021 (11)
2020 (11)
Funding
Current Stage
Late StageTotal Funding
$9.5MKey Investors
National Institutes of Health
2016-10-03Grant· $9.5M
Leadership Team
John E. Niederhuber MD
CEO Inova Translational Medicine Institute
Patrick Christiansen, Ph.D
Chief Executive Officer, Inova Fairfax Medical Campus
Recent News
2025-09-15
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