Patient Financial Services Representative 4 – Medicare Claims

This is a fully remote position, open to applicants in District of Columbia, +10 more states.

📋 Description

• Guarantees that all clean claims are submitted on the same day they are received, using the correct medium and including all necessary attachments. Acts as the supervisor or manager in their absence.

• Addresses intricate issues through individual efforts or by coordinating the information/actions of other team members, Patient Accounts staff, other hospital departments, or at the payer level. Seeks supervisor assistance when necessary.

• Ensures that claims are evaluated, corrections are identified or made, and resolutions are initiated within 24 hours of claims receipt. Recognizes the need for and provides support/guidance to other team members to enhance their efficiency and productivity.

• Manages complex and/or high-dollar accounts while delivering appropriate follow-up according to established protocols or SRGs.

• Ensures timely and accurate documentation of all account activities while appropriately managing all correspondence within 48 hours of receipt.

• Records activities in HealthQuest and TRAC, ensuring that documentation is professional, suitable, accurately reflects actions taken, and adheres to departmental quality review standards.

• Reviews payer response and rejection reports while ensuring compliance with departmental productivity and quality review standards. Maintains knowledge of payer requirements, UB-92 standards, system (Hospital, clearinghouse, payer) functionalities, and hospital policies and procedures.

• Follows management direction to resolve issues while also offering support, education, and guidance to team members. Performs assigned duties in the absence of the supervisor or manager.

• May undertake additional responsibilities as assigned.

⛳️ Requirements

• Education: Associate Degree or an equivalent of three additional years of experience relevant to the role.

• Experience: 3 years of experience in revenue cycle, finance, customer service, or data analytics.

🏝️ Benefits

• Committed to Team Member Health: providing medical, dental, and vision coverage, along with a comprehensive team member wellness program.

• Retirement: Inova matches the first 5% of eligible contributions – beginning on your first day.

• Tuition and Student Loan Assistance: offering up to $5,250 annually in education assistance and up to $10,000 for student loans.

• Mental Health Support: providing all Inova team members, their spouses/partners, and children with 25 mental health coaching or therapy sessions, per person, per year, at no cost.

• Work/Life Balance: featuring paid time off, paid parental leave, and flexible work schedules.