• Job Description

  Req#: 150882

  How You’ll Help Transform Healthcare:

  Onsite is preferred, hybrid or remote work option is available. Candidates residing in the following states can be considered for remote work: Alabama, Florida, Georgia, Arkansas, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, West Virginia, and Virginia.

  
  The Medical Economics Analyst will be responsible for assisting the Medical Economics Director or takes lead in routine and ad-hoc reporting and analytics in support of organization's financial operations and service line teams. Ensures timely, accurate updates of SPR Dashboards. Provides material financial impact analysis and considerations resulting from contract fee schedule updates. Assists in fee schedule updates and troubleshoots variance root cause.

  Duties & Responsibilities may include but not limited:

  • Audits and Reconciles government and commercial insurance fee schedules to ensure they reflect correct, contracted values

  • Performs material financial impact analysis resulting from contracting, payer, government, and market forces

  • Utilizes Strata decision support to identify, analyze, and monitor trends, for ad-hoc or recurring customer needs

  • Maintains rate data base tables for all contracts and provides rate updates to Carilion stakeholders, including revenue cycle and finance

  • Submits rate update files to modeling application vendors: FinThrive and Experian

  • Reconciles payer claims and remittances to validate modeling system accuracy

  • Applies foundational understanding of medical coding systems affecting the adjudication of claims, including ICD-9/10, CPT, HCPCS II, DRG and revenue codes

  • Applies basic knowledge of commercial and government payer trends to assist with modeling and analyzing contract rate proposals

  • Applies basic knowledge of various reimbursement methodologies including, Per Diem, DRG, fee schedules, and percent of charge to modeling and analytic initiatives

  What We Require:

  
  Education: Bachelor’s degree in finance, accounting or business-related field required. Four years of relevant experience may be considered in lieu of Bachelor’s degree.
  
  Experience: 2+ years of related experience with Bachelor’s demonstrating:

  • • Analytical and problem-solving skills
    • Advanced Microsoft Excel skills
    • Clear, effective communication skills
    • Detail orientation

  About Carilion

  
  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.

  
  Requisition Number: 150882
  Employment Status: Full time
  Location: CASB - Carilion Administrative Services Building
  Shift: Day
  Shift Details: FT Day
  Recruiter: MARK A MISKOVIC
  Recruiter Phone:
  Recruiter Email: mamiskovic@carilionclinic.org
  For more information, contact the HR Service Center at 1-800-599-2537.
  
  Equal Opportunity Employer
  
  Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
  
  Carilion Clinic is a drug-free workplace.

• About the company

  Carilion Clinic, formerly known as Carilion Health System, is a Roanoke, Virginia-based non-profit integrated health care organization that provides care for nearly one million Virginians and West Virginians.

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