The Patient Financial Services Representative 2 ensures appropriate and timely documentation of all account activity while appropriately handling all correspondences. Ensures that payer response reports and rejection reports are worked timely and meet departmental productivity and quality review standards. Takes ownership for the timely and accurate editing, submission and/or follow-up of assigned claims. Processes claims for at least one payer type (e.g. Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.) while ensuring all assigned claims meet clearinghouse and/or payer processing criteria. Meets departmental productivity and quality review standards while providing team management with issues regarding the claims follow-up process.
Schedule: Monday - Friday 8:00am-5:00pm (100% On-Site in Fairfax, VA)
Job Responsibilities
- Documents activity in HealthQuest and TRAC.
- Takes direction from management to resolve issues.
- Addresses all correspondences appropriately and within 48 hours of receipt or within customer expectations.
- Ensures that all daily, weekly, and monthly reports are completed and submitted timely and with minimal errors.
- Meets weekly productivity and quality expectations for assigned work lists and any supervisor-assigned special tasks.
- 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.
- Maintains knowledge of payer requirements, UB-04 standards, and system (i.e. Hospital, clearinghouse, payer) functionality in addition to Hospital policies and procedures.
- May perform additional duties as assigned.
Additional Requirements
Certification - Not requiredLicensure - Not requiredExperience - One year of experienceEducation - High School or GED
We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Every day, our 24,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better — to shape a more compassionate future for healthcare.
Inova Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.
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