• Job Description

  Req#: 665628

  Inova Fairfax Hospital is looking for a dedicated Patient Financial Services Representative 3 - Billingual 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 - Billingual 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.

• About the company

  Inova Health System is a non-profit health organization based in Falls Church, Virginia, near Washington, D.C. The system is a network of hospitals, outpatient services, assisted living and long-term care facilities, and healthcare centers.

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