Billing Specialist - Level 1 Biller

JOB SUMMARY: ·The Level 1 Biller supports the billing department by handling routine claim submissions after EHR scrub, payment posting, simple claim corrections, clearinghouse rejections, and patient aging follow-up across counseling, pediatric therapy, and autism therapy. Insurance verification and credentialing are excluded from this role.

QUALIFICATIONS:

Minimum Qualifications

· 1–2 years of medical billing or revenue cycle experience.

· Familiarity with PM/EMR workflows, clearinghouses, ERAs/EOBs.

· Working knowledge of CPT/HCPCS and basic modifiers.

· Excel/Sheets proficiency for trackers and logs; strong attention to detail.

Preferred Qualifications

· Behavioral health/therapy billing experience.

· Experience with patient AR follow-up and statement cycles.

· Basic understanding of coordination of benefits (COB).

Performance Metrics (KPIs)

· Claim submission turnaround: ≤48 hours from service completion.

· First-pass acceptance rate: ≥95%.

· ERA posting turnaround: Same day or next business day.

· Patient AR >90 days: trending down month-over-month; documented follow-ups.

Essential Functions, Knowledge, Skills and Abilities:

· · Claim Review & Submission: Monitor EHR scrub results; correct simple edits; submit clean claims via clearinghouse/payer portals.

· Payment Posting: Post ERAs/EOBs, adjustments, and patient payments; reconcile deposits; manage unapplied cash.

· Clearinghouse Rejections: Resolve standard rejections (e.g., CO-4, CO-16, invalid member ID) and resubmit corrected claims.

· Patient Aging: Own patient AR for all lines; send statements; make courtesy calls; set follow-up cadence; escalate to Level 3 for payment arrangements.

· Documentation & Reporting: Maintain logs of submissions, postings, and patient aging actions; prepare weekly exceptions summary for Level 2/3.

· Maintain current knowledge of and compliance with all applicable local, state, and federal laws and regulations (HIPAA, HiTECH, etc.) regarding the protection, storage, and disclosure of patient health information.

· Refrain from acts of fraud, deceit, and/or misappropriation of company information or funds

· Avoid intentional and willful misconduct that may subject the company to criminal or civil liability or adversely affect the company’s goodwill or reputation

· Timely and promptly notify Executive Leadership of any acts or omissions of their own and other employees’ conduct that could threaten or compromise the safety or quality of care administered to patients, or that could threaten the interests of the company, financial or otherwise

· Render, provide, and facilitate employment duties in a faithful, industrious manner, and to the very best of their skill, care, diligence, and attention

Disclaimers:

· The above duties and responsibilities are essential job functions, subject to reasonable accommodations. All job requirements listed above indicate the minimum level of knowledge, skills and/or abilities deemed necessary to perform the job satisfactorily and proficiently. Refer to company handbook and/or clinical policies/procedures for additional employment-related requirements.
This job description is not intended to be construed as an exhaustive statement of duties, responsibilities or requirements. Employees may be required to perform any other job-related instructions, as requested by their supervisor/management.

Job Type: Full-time

Pay: From $20.00 per hour

Work Location: Remote