Physician Insurance Analyst 4

Inova · United States

Inova is looking for a dedicated Physician Insurance Analyst to join the team. This role will be Full-Time Monday through Friday Hybrid. 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, flexible work schedules, and remote and hybrid career opportunities

• Performs the duties of a Physician Insurance Analyst 1, 2, and 3 and demonstrates leadership by providing training to new staff or deploying insurance updates to existing staff.
• Responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims, while meeting the expected Productivity and Quality Standards on a weekly basis.
• Processes claims for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.) and processes all types of EPIC charge reviews and claim edits. Assure all assigned claims meet clearinghouse and/or payer processing criteria.
• Processes Appeals (levels 1 and 2) and checks claim status via phone/payer website for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.).
• Identifies trends and analyzes data, escalating trends to the appropriate leader/teams.
• Ensures payer response reports and rejection/denials reports are worked timely and meet Departmental Productivity and Quality Review Standards.
• Effectively interprets CPT, ICD-10, and APC reimbursements to ensure a strong receivable performance.
• Demonstrates ability to effectively use and navigate all payer portals, and effectively trains new team members on all payer portals.
• Works on special projects related to claims and denials follow-up. Leads special projects related to claims and denials follow-up, and may perform other additional duties as assigned.

• Education - High School or GED
• Experience - 3 years Account Executive Experience in Revenue cycle operations, billing, collections, cash posting, and/or administrative support in physician billing