CLINIC BILLING SPECIALIST

Job Description

Job Description

Horizon Health is a Critical Access, Rural Health Facility comprised of 25-inpatient beds located in Paris, IL & a multitude of outpatient clinic settings including Family Practice and Specialty Clinics in Paris and surrounding cities. We have been serving residents of Edgar County since 1968 though community education, emergency services, and outpatient care. As we continue to expand our services & locations, our community has grown far beyond Paris. Our rich history and strong community support pave the way for the future of healthcare as we serve you—our family, friends, and neighbors.

Position Summary:

The medical billing specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities for Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers which includes Worker's Compensation and Auto claims as well as Corporate contracts. The medical billing specialist must possess critical thinking skills and an understanding of rules and guidelines for all payers to manage accounts in an accurate and timely manner. In addition, the medical billing specialist must demonstrate proficiency within the EHR (Electronic Health Record) to ensure all functionality is utilized for the utmost efficient processing of claims.

Essential Functions (Responsibilities/Accountabilities):

• Accurately completes the billing process for Medicare, Medicaid, Commercial, WC, Auto and Corporate Contracts which includes knowing timely guidelines and payer specific rules and regulations.
• Maintains and documents organized records and files of all correspondence with insurances companies and patients which includes accurate and detailed claim notes of all f/u.
• Works independently while utilizing initiative and judgement in carrying out work details which includes multi­tasking and time management to ensure the most effective use of time.
• Updates patient information and insurance information in the EHR system per phone calls with patients and/or insurance companies to get the most up to date information
• Utilization of payer portals to retrieve accurate billing information which includes patient eligibility and claims status.
• Performs f/u on claims in a timely manner to avoid timely denials.
• Works with supervisor and coding team members to resolve claim denials derived from coding denials.
• Processes corrected claims based on payer specific guidelines.
• Completes appeals process on line or via paper submission with supporting documentation
• Ability to analyze and interpret that claim denials are accurately sent to insurance companies.
• Process billing/insurance calls and questions from patients, providers offices, registration and patient service's staff.
• Ability to take payments, print billing summaries, send medical records for claim based requests.
• Ability to identify trends, and carrier issues relating to billing and reimbursements. Report finding to supervisor if large impact.
• Creates cases with EHR customer service when necessary.

The responsibilities listed above are not all-inclusive; other activities may be required in support of the facilities goals and objectives.

Position Requirements:

• High School graduate or GED
• Prior billing office experience preferred
• Able to use office equipment - computer, copier, fax, etc.
• Ability to analyze and reconcile billing statements
• Ability to communicate effectively and tactfully with patients and insurance companies
• Proficient use of Word and Excel
• Previous experience utilizing EHR preferred

Pay Range:

Pay ranges from $15.750/hour to $25.216/hour (rate of pay is based on applicable years of experience)

Position Information:

Location: 908 North Main Street Paris, IL 61944

Hours: Monday- Friday 8am-5pm

Horizon Health is committed to caring not only for our patients, but for our staff as well. We offer you an extensive total compensation and benefits package. As an employee of Horizon Health, your benefits include a competitive salary, medical, dental and vision insurance, Employee 403(b), health savings account with Company match, as well as Vacation, Sick and Paid Holidays.

Access to our benefits summary can be found by clicking the link below!

-benefits-summary.pdf

Intrigued? Don’t wait, apply today. We are actively reviewing applicants for the Clinic Billing Specialist. Be part of an organization that is dedicated to the growth and development of its colleagues. Here at Horizon Health, our employees speak for themselves. Join our family & begin an incredible career!