Insurance and Billing Specialist

Job Description

Job Description

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 serves as the front-line insurance resource for our Navigation Team, supporting real-time patient interactions and ensuring accurate front-end data collection. You will act as a key bridge between Navigation, Operations, and Revenue Cycle, helping to verify coverage, troubleshoot insurance questions, and flag billing risks before they occur.

This role reports directly to the Practice Manager and maintains a dotted-line relationship to the VP of Revenue Cycle to ensure alignment on payer updates, coding accuracy, and compliance standards.

This is a dynamic role for someone who thrives in a fast-paced, call-center environment, enjoys solving problems in real time, and takes pride in helping both patients and teammates succeed.

A DAY IN THE LIFE

• Serve as the go-to support for Navigators on live insurance questions during patient encounters
• Verify insurance coverage and assist Navigators in confirming plan participation in real time
• Partner with the VP of Revenue Cycle to identify recurring payer issues or training opportunities
• Ensure accurate insurance data entry for billing and claims processing
• Assist in creating and sending invoices for case-rate and other billing scenarios as needed
• Perform quick front-end audits to validate patient demographics and insurance details
• Research uninsured or unknown insurance cases to identify potential coverage
• Provide insights to Operations and Navigation Leadership on trends affecting payment or coverage
• Participate in monthly QA reviews to identify process improvements in insurance workflows

Requirements

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.

Insurance Verification Expertise : Understanding of eligibility checks, payer portals, and plan participation nuances

Call Center Efficiency : Ability to multitask, prioritize, and support multiple Navigator requests quickly and accurately

Attention to Detail : Accuracy in patient and insurance data entry, ensuring clean claims and minimized rework

Collaboration : Ability to bridge communication between Navigation, Operations, and Revenue Cycle teams

Problem Solving : Resourceful and proactive in identifying insurance barriers and providing real-time solutions

Communication : Clear and professional communication with teammates, health plans, and billing partners

Benefits

We hire extraordinary employees who thrive in an environment based on our 6 Guiding Values. Benefits of working with us include :

OUR GUIDING VALUES

At RightSite Health, we do more than profess our values. We practice them through an agreed-upon and shared set of behaviors that make up our DNA. We are clear about what is important to us, and we take care that our intentions, words, thoughts, and behaviors align with those values.

Teamwork : We have the courage to ask for help and fearlessly share information with team members. We are driven to help each other and share in the wins and losses.

Integrity : We are respectful, genuine, and openly hear and speak the truth. We are confident in our own abilities, but we think of others first.

Customer Focus : We deliver value and treat our customers with the same care, compassion, and empathy we would expect ourselves. We are committed to improving the lives of our customers, their customers, and each other.

Tenacity : We recognize ambiguity and discomfort are part of success, and approach change with positivity. We accept adversity, overcome obstacles, and never give up.

Ownership : We take personal accountability for our actions and results and focus on solving the problem instead of assigning blame. We are free to place bets and embrace failure for its feedback and experiences.

Critical Thinking : We start with why, listen carefully and investigate thoroughly before drawing conclusions. We think slow, not fast, in search of elegant and simple solutions.