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Insurance and Billing Specialist at RightSite Health. WHO WE ARE. We are changing how EMS navigates care! RightSite partners with EMS on-site to connect non-emergent patients with a Telehealth ER Doctor and navigate them to the right site of care. Patients instantly access an ER Telehealth Doctor and a Patient Navigator who provide a trusted, genuine human connection in a time of need. EMS becomes more available for critical emergencies while we deliver higher quality care at a lower cost and better experience for everyone.. WHO YOU ARE. The Insurance and Billing Specialist will be responsible for managing all aspects of the billing cycle, from insurance verification to claim submission and reconciliation. This dynamic role requires a strong understanding of medical billing practices, attention to detail, and the ability to work independently as well as collaboratively with other departments. As a crucial member of our team, you will leverage your expertise to optimize revenue cycles, ensure compliance with industry regulations, and contribute to the financial health of our organization. Your skills in navigating complex insurance systems and resolving billing discrepancies will be instrumental in maintaining smooth operations and enhancing patient satisfaction.. If you would like the opportunity to make a tangible impact on community health while working for a dynamic, mission-driven organization, we would love to hear from you! . A DAY IN THE LIFE. . Verify insurance coverage and ensure accurate loading of insurance information for billing purposes. . Submit claims to our billing partner . . Create invoices for case rates and other billing scenarios as needed. . Perform front-end edits on patient demographics, correcting information such as date of birth, addresses, and member IDs. . Conduct claim audits and reconciliations to ensure all services are accounted for and billed correctly . . Research uninsured and unknown insurance cases to identify potential coverage. . Assist in the implementation and testing of billing automation processes. . Perform ongoing audits of billing automations to ensure accuracy and efficiency. . Serve as a liaison with Operations, identifying opportunities for improvement in front-end data collection. . Serve as a SME (Subject Matter Expert) for Navigators on insurance-related questions. . . Bachelor’s degree in healthcare administration, business, or related field or equivalent experience. . Minimum 2 years of experience in medical billing and insurance verification. . Proficiency in medical billing software. . Strong knowledge of CPT and ICD-10 coding. . Familiarity with HIPAA regulations and privacy standards. . COMPETENCIES . At RightSite Health, we are big believers in competencies. Competencies are different from technical skills or experience. Technical skills describe the 'what' you do, whereas competencies describe 'how' you do it. Following is a list of competencies required for success in this role..  . Medical Billing Expertise: . Comprehensive knowledge of medical billing practices, insurance claim processes, and healthcare reimbursement systems. This includes understanding various coding systems, payer requirements, and regulatory compliance.. Attention to Detail:. Meticulous focus on accuracy when handling patient information, insurance data, and financial records. This skill is crucial for minimizing errors in claim submissions and ensuring proper revenue capture.. Problem Solving Skills:. Ability to analyze complex billing issues, identify discrepancies, and develop effective solutions. This competency is essential for resolving claim rejections, auditing billing processes, and optimizing revenue cycles.. Communication:. Proficiency in clearly conveying to health plans billing irregularities and working with them to resolve issues.. Technical Proficiency:. Strong aptitude for using billing software, Excel and data analysis tools. This competency is vital for managing automated billing processes, conducting audits, and improving operational efficiency.. Company Location: United States.