CLINIC BILLING SPECIALIST

Horizon Health is a Critical Access, Rural Health Facility comprised of 25‑inpatient beds located in Paris, IL and 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 through community education, emergency services, and outpatient care. As we continue to expand our services and 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, and documenting related account activities for Medicare, Medicaid, Medicaid Managed Care, commercial insurance payers, Worker's Compensation, Auto claims, and Corporate contracts. The specialist must possess critical thinking skills and an understanding of rules and guidelines for all payers to manage accounts accurately and in a timely manner. In addition, the specialist must demonstrate proficiency within the Electronic Health Record (EHR) 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, including knowing timely guidelines and payer‑specific rules and regulations.
• Maintains and documents organized records and files of all correspondence with insurance companies and patients, including accurate and detailed claim notes of all follow‑ups.
• 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 obtain the most up‑to‑date information.
• Utilizes payer portals to retrieve accurate billing information, including patient eligibility and claim status.
• Performs follow‑ups 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 online or via paper submission with supporting documentation.
• Analyzes and interprets claim denials to ensure they are accurately communicated to insurance companies.
• Handles billing/insurance calls and questions from patients, provider offices, registration, and patient service staff.
• Manages payments, prints billing summaries, and sends medical records for claim‑based requests.
• Identifies trends and carrier issues relating to billing and reimbursements, reporting findings to supervisor if of 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 facility’s goals and objectives.

Position Requirements

• High School graduate or GED.
• Prior billing office experience preferred.
• Ability 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, 8 am‑5 pm

Horizon Health is committed to caring not only for our patients but for our staff as well. We offer 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, and Vacation, Sick, and Paid Holidays.

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

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 and begin an incredible career!