Inova Fairfax Hospital is looking for a dedicated Patient Financial Services Representative 3 to join the team. This role will be on-onsite, full-time day shift from Monday - Friday, 8:00 a.m. - 5:00 p.m.

The Patient Financial Services Representative 3 performs the duties of a Patient Financial Services Representative 2 and is responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims. Processes claims for at least two payer types (i.e. Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.) and ensures that all assigned claims meet clearinghouse and/or payer processing criteria. Ensures appropriate follow-up on assigned work lists while meeting all departmental productivity and quality review standards. Provides team management with issues regarding the claims follow-up process. Ensures that payer response reports and rejection reports are worked on in a timely and meet departmental productivity and quality review standards.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. 

 

Featured Benefits:

Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions – starting on your first day. Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: 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. Work/Life Balance: offering paid time off, paid parental leave, and flexible work schedules

Patient Financial Services Representative 3 Job Responsibilities:

Ensures that all clean claims are submitted the day they are received, submitted via the appropriate medium, and with all required attachments. Reviews claims, identifies/makes corrections or initiates resolution within 24 hours of the date the claim was received. Documents and reports claims submission issues immediately and provides feedback to team management regarding issues and wins. Provides resolution for pending (WIP backlog) claims within allowable timeframes, as defined for appropriate deficiency, and/or provides appropriate account follow-up based on established protocol or SRGs. Completes write-off requests and submits to supervisor for daily review. Appropriately documents activity in HealthQuest and TRAC. Completes and submits all daily, weekly, and monthly reports with minimal errors. Maintains knowledge of payer requirements, UB-04 standards, and system (i.e. Hospital, clearinghouse, payer) functionality in addition to Hospital policies and procedures. Ensures documentation is professional, appropriate, accurately depicts actions performed, and is in accordance with departmental quality review standards. May perform additional duties as assigned.

 

Patient Financial Services Representative 3 Requirements:

Work Schedule: 8-hour shift (Monday - Friday days, 8:00 a.m. - 5:00 p.m.) Education: High School or GED Experience:  Two years of experience in revenue cycle, finance, customer service or data analytics

Patient Financial Services Representative 3 Preferred Requirements:

Bilingual in Spanish strongly preferred, with the ability to communicate effectively with diverse patient populations. Proficiency in hospital billing systems (e.g., Epic) and insurance verification portals.  Insurance & Compliance Knowledge: Extensive understanding of Medicaid, Medicare, commercial insurance, and self-pay policies. Familiarity with HIPAA regulations and hospital financial assistance programs. Analytical & Problem-Solving Skills: Ability to analyze patient accounts, identify discrepancies, and resolve billing or insurance issues effectively.