BILLING AND PRIOR AUTHORIZATION SPECIALIST
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.
About the role
Responsible for completing prior authorizations with insurance companies for Home Care services, submission of patient claims, assisting in clerical office duties, and other duties as assigned. Supports Home Care activities and departmental staff as needed. Follows all policies and procedures established by Horizon Health and maintains confidentiality of departmental work.
Responsibilities
- Implements efficient and timely prior authorizations for patient home care services.
- Completes billing and submission of claims.
- Ensures that patient accounts are maintained according to accepted accounting principles and in accordance with all state, federal, and accreditation standards.
- Monitors accounts receivables and resubmits bills as needed on overdue accounts and prepares reports for administrator regarding bad debt.
- Demonstrates knowledge of all payer contracts and follows specific requirements of the account when submitting claims.
- Reconciles Medicare reimbursement reports from the intermediary with the internal billing information systems.
- Maintains confidentiality of patient and agency information.