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 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 payorâs 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.
Required to examine outstanding insurance claims and/or explanation of benefits statements with the ability to work with multiple computer systems. Learns all aspects of the particular insurance payer(s) assigned while gaining significant knowledge of CPT coding, ICD10 diagnosis, modifiers, and their appropriate use on the claim forms. Routinely submits initial claims, resubmits corrected claims, and appeals denied claims, both electronically and manually. Interacts with other employees, insurance companies, leads, supervisors, managers, off-site personnel, and patients. Maintains the highest level of confidentiality of all information while accomplishing multiple tasks in a timely manner. Demonstrates a consistently high level of productivity and quality standards.
Shift Details Required M-F, 8:00-4:30 pm