Level I Biller

Level I Biller

The Level I Biller is responsible for managing insurance verifications, prior authorizations and patient account pre‑collections. This role ensures timely and accurate processing of insurance documentation, effective communication with patients and providers, and proactive resolution of billing and payment issues. The specialist maintains detailed records, generates reports and collaborates closely with clinical and billing teams to support overall revenue cycle efficiency.

Exceptional customer service, strong communication skills and the ability to work both independently and collaboratively are essential to success in this role.

• Prior Authorization & Insurance Verification – Verify patient insurance coverage and benefits for services, procedures, and medications, utilizing online portals, phone calls, or other resources.
• Determine if prior authorization is required for scheduled services or prescribed medications.
• Prepare and submit prior authorization requests to insurance companies, ensuring all necessary documentation (including medical records and clinical justifications) is included.
• Track the status of pending authorizations, follow up with insurance companies for approvals or denials, and elevate complex cases as needed.
• Communicate authorization status and potential financial responsibility to patients and referring providers.
• Pre‑Collections & Patient Account Management – Review patient accounts and identify overdue balances or potential collection issues.
• Proactively contact patients regarding upcoming procedures or services that require payment prior to the date of service.
• Discuss payment options with patients and establish payment plans as appropriate, in accordance with clinic policies.
• Answer patient inquiries regarding billing statements, insurance coverage, and financial responsibility.
• Initiate outbound calls to follow up on overdue accounts and discuss payment arrangements.
• Administrative & Reporting – Maintain accurate and detailed records of all prior authorization and collections activities within the patient's record.
• Generate and review reports on accounts receivable, pending authorizations, and other relevant metrics. Identify and report trends in insurance denials or patient collection issues to management.
• Stay up to date on changes in insurance policies, billing regulations and collection practices.
• Collaborate with the billing department and other relevant staff to resolve complex billing issues and ensure accurate submission of claims.
• Contribute to team effort by accomplishing all related tasks as needed.
• Provide superior customer service excellence at all times.
• Remain flexible on behalf of the position and the team.
• Interact positively and professionally through multiple departments within the practice.
• Work independently as well as within a team environment.
• All other duties as assigned.

• High School diploma or equivalent required.
• Experience in healthcare billing, prior authorization or collections required.
• Strong knowledge of medical terminology, coding (CPT, ICD‑10) and healthcare regulations (e.g., HIPAA).
• Demonstrated experience with insurance verification and prior authorization processes.
• Proficiency in electronic health record (EHR) systems and medical billing software.
• Excellent written and verbal communication skills and interpersonal skills.
• Strong organizational skills, attention to detail and ability to manage multiple tasks and deadlines.
• Problem‑solving abilities and a proactive approach to addressing challenges.

Seniority level:
Entry level

Employment type:

Full‑time

Job function:
Accounting / Auditing and Finance – Industries:
Medical Practices