Enterprise Insurance Verifier- Patient Financial Services

Inova Health is looking for a dedicated Enterprise Insurance Verifier to join the Patient Financial Services team. This remote role will be full-time day shift from Monday - Friday between 8:00 a.m. - 5:00 p.m.

The Patient Financial Services (PFS) Enterprise Insurance Verifier ensures timely verification of patient insurance coverage to support access to care across Inova. This role collaborates with teams and maintains knowledge of payer guidelines to ensure accurate claims processing and reimbursement.

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

Enterprise Insurance Verifier Responsibilities:

• Maintains productivity and accuracy standards as measured by work list completion, observation, and quality assurance.
• Serves as a Liaison between physicians, patients, and insurance to ensure all elective scheduled patients obtain authorizations.
• Ensures all precertification/authorizations are obtained timely. Enters amounts so payment arrangements can be made prior to the point of service. Performs verification of benefits, electronically or by telephone, according to department procedures/guidelines.
• Makes appropriate referrals to the self-pay team for County Medicaid, Non-County Medicaid, Emergency Medicaid, SLH, IHCTF, IFH, and/or MediCredit. Complies with department procedures and regulatory guidelines for Medicare Secondary payroll and ABN.
• Follows coordination of benefits and Medicare Secondary Payer guidelines to determine primary and secondary payer status. Follows department procedures for practice management documentation standards and updating accounts in Epic.
• Identifies and obtains required precertification, authorizations, and/or referrals while entering all information into the appropriate registration and billing system(s). Creates estimates through Carepricer for all scheduled elective patients.
• Completes the appropriate due diligence for each account when speaking with patients and follows Inova Health System's approved script as a guide regarding what to say and what not to say to patients.
• Identifies payment source and secures all information required to ensure a billable and collectible account while avoiding penalties, denials, and/or bad debt write-offs.

Minimum Qualifications:

• Education: High School or GED
• Experience: Three years of previous experience working in a hospital or healthcare facility in registration, patient accounts or physician billing office required; OR a combination of experience/education; (AA Degree = one year; Bachelor's Degree = two years)

Preferred Qualifications:

• Strong knowledge of insurance authorization and precertification processes for elective procedures, including commercial, Medicare, Medicaid.
• Proficient in Epic or comparable electronic health record and registration systems; experience with documentation and account updates per practice management standards.
• Strong understanding of payer portals, real-time eligibility tools, and benefit verification workflows, with ability to verify coverage both electronically and via phone.
• Effective communicator with proven experience serving as a liaison between patients, providers, and insurance companies to resolve coverage and authorization issues in a timely manner.
• Experience with financial counseling referrals for Medicaid and self-pay assistance programs, including coordination with internal or external eligibility vendors

Remote Eligibility: This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV