Carilion Clinic RCM Analyst in Roanoke, Virginia
Take this rare opportunity to apply your skills to a dynamic new setting. Keep vital teams organized, informed, and fully prepared to succeed. Give your work additional significance with Carilion Clinic, a community-based healthcare network that includes seven hospitals, multi-specialty physician practices, and affiliations with prestigious academic medical institutions.
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.
3+ years of medical billing experience preferred
High school diploma or equivalent
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
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
Based in Roanoke, Virginia, we are dedicated to inspiring optimal health through compassionate care, medical education and research, and neighborhood outreach programs. Join us, and learn how collaborating with a regional leader cited for clinical and workplace excellence can improve the quality of your career experience with unquestioned stability, supportive management, and real advancement potential.
Education: High School graduate required; extended college course work preferred in Business or Accounting
Experience: Three years of experience in specified area or other applicable experience required. Communication, analytical and problem-solving skills required. Proficiency in EPIC Fundamentals required. EPIC Administrator preferred
Other Minimum Qualifications: Must be able to meet high productivity and accuracy standards. High focus and concentration needed for computer, analytical, organizational and time management required. Visual perception and high hand/eye coordination necessary. 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.
Below are our core values that we strive to embody and expect of all our team members:
CommUNITY: Working in unison to serve our community, our Carilion family and our loved ones.
Courage: Doing what’s right for our patients without question.
Commitment: Unwavering in our quest for exceptional quality and service.
Compassion: Putting heart into everything we do.
Curiosity: Fostering creativity and innovation in our pursuit of excellence.
Requisition Number: 24043
Employment Status: Full time
Location: CASB - Carilion Administrative Services Building
Shift Details: M-F 8-4:30 with overtime when needed
Recruiter: KIMBERLIE A GONCE
R Recruiter Email: firstname.lastname@example.org
As a not-for-profit organization, we pride ourselves on investing in our employees and the communities we serve.
Our employees strive to provide quality care in serving over 1 million residents in Virginia while living and growing their careers in the country's most livable cities and towns.
Headquartered in Roanoke, Va., Carilion Clinic is a robust system of small and large 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.
Equal Opportunity Employer
Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
Carilion Clinic is a drug-free workplace.