Medical Billing Analyst- PB Medicare

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.

The Medical Billing Analyst maintains knowledge of billing area assigned.

This is an insurance follow up position collecting payments from Medicare and other responsible parties for physician claims. Prior physician billing experience desired. Must be able to meet production and quality standards. Looking for self-motivated person who is extremely organized and able to multi task. Critical thinking skills needed. Must be able to meet deadlines. Excellent communication skills desired.
Biller/Collector is primarily responsible for billing and follow-up of claims. The right candidate will possess a strong knowledge of third party payers, and standardized coding (billing, not medical).  Candidate will have worked previously with a billing clearinghouse (ZirMed, Emdeon, SSI, etc.). Must have the ability to work efficiently both independently and as a team, with the foresight to assure all information on claims is correct and clean, and that follow-up is completed per company policy. Looking for someone with an outgoing and "can do" attitude. Candidate should be self-motivated and up for the challenge of getting the job done.
•    Prepare, review, and transmit claims using automated systems and, in some cases, a manual paper claim process
•    Knowledge of insurance guidelines, including HMO, PPO, Exchange, and other Governmental plans
•    Follow up on unpaid claims within specified billing cycle timeframe
•    Validate insurance payment for accuracy and compliance based on contractual terms
•    Evaluate and investigate payor matters for any discrepancy in payments as necessary
•    Identify and bill secondary payors
•    Follow-up on all accounts with payor
•    Follow-up on payor specific appeals and denial of claims.
•    Ensure compliant collection efforts interpreting the explanation for benefits (EOB)
•    Document into the Patient Accounting system, as necessary, including, but not limited to: claim submission information and all follow-up attempts.
•    Other duties as assigned
•    3+ years of medical billing experience preferred
•    Experience billing professional and physicians' charges to insurance companies
•    Experience reading electronic claim files
•    Knowledge and competency to use medical claims clearinghouse system  
•    Possess strong organizational and follow up skills.
•    Proficient with Microsoft Office products (Excel and Word)
•    Familiarity with HCFA 1500 & UB-04

M-F 8-4:30 with overtime if needed

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: 79199 
Employment Status: Full time 
Location: CASB - Carilion Administrative Services Building 
Shift: Day 
Shift Details: M-F 8-4:30 with overtime if needed
Recruiter Email: kagonce@carilionclinic.org

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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