Medical Billing Analyst- PB Medicaid Managed Care

Roanoke, VA, US, 24011

Job Summary

Welcome to a promising future with this unique career opportunity. At Carilion Clinic, our team provides general billing support for Revenue Cycle in a forward-thinking environment. You will thrive through extensive training, supportive leaders and potential for advancement. Carilion offers comprehensive benefits, paid time off, and tuition options. Join a team where your skills and ideas will make a difference in the health of our patients and the communities we live in.

This position on the PB Medicaid MCO team will concentrate on credit balances, insurance overpayments, and refunds while monitoring payor overpayment trends for the team.
M-F 8 - 4:30 with overtime as required.

The Medical Billing Analyst maintains knowledge of billing area assigned. This position works under limited supervision and may look to the Team Lead or Manager for help in answering questions and furthering education around task completion. The Medical Billing Analyst uses discretion/ good judgment in dealing with confidential patient protected information. Works in a fast-paced, office environment with high productivity and accuracy standards that requires focus and concentration on tedious details and research.

The job duties for the Medical Billing Analyst includes, but is not limited to, the following:

  • Processes and monitors claims in work queues to the point of resolution and determines appropriate action and follow-up.
  • Conducts analysis of issues holding up accounts and follows guidelines established by Revenue Cycle Billing Manager to achieve successful adjudication from the third party payor assigned.
  • Maintains a working knowledge of assigned payor’s specific operating policies and guidelines.
  • Recognizes the varying timeframe requirements as assigned by payor and is the primary line of defense in resolving timely filing and other straight forward denial issues.
  • Completes timely handling of mail and phone messages.
  • Reviews the SSI (electronic claim production) download in order to execute basic claim edits and document all work effort within the appropriate system.

Minimum Qualifications

Education: High School graduate required (or equivalent); some college education preferred.

Experience: Two years of applicable experience desired.

Other Minimum Qualifications: Effective communication, analytical, problem-solving, and critical thinking skills required. Excellent interpersonal skills required. Requires excellent hearing, clear/concise speech, excellent finger dexterity to operate computer terminal/keyboarding as well as use of a calculator.  Must be proficient with word processing, computer/PC skills.  Excellent documentation and follow-up skills required.


Our Values

Below are our core values that we strive to embody and expect of all our team members:

Collaboration: Working together with purpose to achieve shared goals.

Commitment:  Unwavering in our quest for exceptional quality and service.

Compassion:  Putting heart into everything we do.

Courage:  Doing what’s right for our patients without question.

Curiosity:  Fostering creativity and innovation in our pursuit of excellence.


Requisition Number: 73897 
Employment Status: Full time 
Location: CASB - Carilion Administrative Services Building 
Shift: Day 
Shift Details: M-F 8 - 4:30 with overtime as required.
Recruiter Email: kagonce@carilionclinic.org
For more information, contact the HR Service Center at 1-800-599-2537.

This is Carilion Clinic ...

An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning
hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.

Equal Opportunity Employer

Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity

Carilion Clinic is a drug-free workplace.


Nearest Major Market: Roanoke

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