RCM Insurance Specialist
Quest Health Solutions LLC•West Plains, MO
•Onsite
About The Position
Quest Health Solutions is seeking a detail-oriented and process-driven Insurance Systems & Configuration Specialist to support our Revenue Cycle and Resupply operations. This role is responsible for maintaining payer and insurance configuration accuracy within Brightree and related systems, ensuring clean claim flow, reducing billing issues, and supporting operational efficiency across teams.
Requirements
- Previous experience in healthcare revenue cycle management, DME, medical billing, insurance verification, or payer configuration.
- Strong understanding of payer structures, insurance workflows, and claim processing requirements.
- Familiarity with Brightree, payer setup and maintenance, E-claim configuration, insurance validation workflows, and revenue cycle operations.
- Ability to review and resolve incomplete demographic and insurance-related WIPs, including missing policy numbers, insurance changes, invalid coverage information, and demographic discrepancies impacting billing or order processing.
- Strong attention to detail with the ability to audit insurance verifications, review payer configurations for accuracy, identify trends, and proactively resolve issues before they impact claims or operations.
- Demonstrated ability to research, analyze, and resolve complex insurance, payer, or claim routing issues efficiently while identifying root causes and process improvement opportunities.
- Strong verbal and written communication skills with the ability to collaborate effectively with internal teams and insurance providers to obtain and validate accurate information.
- Excellent organizational and time management skills with the ability to manage multiple priorities, maintain accuracy in a fast-paced environment, and ensure timely follow-up and resolution of outstanding issues.
Nice To Haves
- Experience troubleshooting payer or configuration issues preferred.
Responsibilities
- Perform quality assurance reviews on insurance configurations and payer setups
- Manage payer setup, maintenance, and configuration updates within Brightree
- Configure, validate, and troubleshoot electronic claim (E-claim) setups
- Review and correct payer addresses and insurance routing information
- Identify and correct payer or insurance setup issues that could impact claims processing
- Audit reorder insurance verifications for accuracy and completeness
- Work and resolve Incomplete Demographic WIPs, including: Missing policy numbers, Insurance policy changes or updates, Incomplete or invalid insurance information, Demographic discrepancies impacting order processing or billing
Benefits
- Comprehensive suite of benefit offerings to support the health, well-being, and financial health of our employees and their families.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
