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Inova Health System
Overpayment Specialist 2
Career Insights for Eligibility Specialist
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Based on Virginia data
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$51,852 / year median in Virginia
+20% projected growth
Job Description
Overpayment Specialist 2 Inova Health System
- 3.
- Friday, 8:00 a.m.
- 5:00 p.m. (Hybrid
- Must Report On-Site Two Times per week) The Overpayment Specialist 2 is responsible for the timely and accurate resolution of patient and insurance credit balances by researching overpayments, validating refund eligibility, and processing refunds in accordance with payer contracts, federal and state regulations, and organizational policies.
Featured Benefits:
Committed toTeam 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 Overpayment Specialist 2Job Responsibilities:
Reviews patient and insurance accounts with credit balances to identify the cause of overpayments and determine the appropriate resolution, including refunds, adjustments, or transfers. Processes patient and insurance refund requests accurately and within established turnaround times while ensuring compliance with organizational policies, payer guidelines, and applicable federal and state regulations. Researches payment discrepancies, duplicate payments, coordination of benefits issues, and billing errors to ensure proper disposition of account credits. Verifies refund eligibility by reviewing payment history, explanation of benefits (EOBs), contractual obligations, and account documentation. Coordinates with Patient Financial Services, Revenue Cycle, Patient Access, Billing, Coding, Compliance, and insurance carriers to resolve outstanding credit balances and refund inquiries.Minimum Qualifications:
Education:
High School or GED Experience :
2 years of experiencePreferred Qualifications:
Experience accurately posting payments, adjustments, and denials in EPIC from electronic and manual remittance advices (ERAs/EOBs). Strong ability to review and research remittance advices to ensure proper payment application and resolve discrepancies. Proficiency in investigating and resolving unapplied or misapplied cash deposits in a timely manner. Experience reconciling daily deposits with bank statements and EPIC postings to ensure financial accuracy. Familiarity with month-end and year-end reconciliation processes. Ability to identify and escalate payment issues, trends, or system errors to management.Benefits
- Paid Time Off (PTO)
- Professional Development
- Mental Health
- Health and Wellness Programs