Billing & Insurance Specialist - Revenue Cycle Expert

Gavroche; San Antonio (TX); On-site; USD 52,000 - 65,000; Full time

Job summary

RightSite Health is seeking an Insurance and Billing Specialist to manage the full billing cycle, from insurance verification to claim submission and reconciliation. This role demands accuracy, independence and collaboration with Operations to optimize revenue and compliance.

You will verify coverage, submit claims, create invoices, edit demographics, and conduct audits. Knowledge of CPT/ICD-10, HIPAA, and billing software is essential. A healthcare administration or related degree is required.

Qualifications

• 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.

Responsibilities

• 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

Skills

Billing accuracy

Attention to detail

Problem solving

Communication

Independent worker

Education

Bachelor's degree in healthcare administration, business, or related field or equivalent experience

Tools

Medical billing software

Job description

RightSite Health is seeking an Insurance and Billing Specialist to manage the full billing cycle, from insurance verification to claim submission and reconciliation. This role demands accuracy, independence and collaboration with Operations to optimize revenue and compliance.

You will verify coverage, submit claims, create invoices, edit demographics, and conduct audits. Knowledge of CPT/ICD-10, HIPAA, and billing software is essential. A healthcare administration or related degree is required.