Revenue Cycle and Billing Specialist

BrightStar Care of Louisville•Douglass Hills, KY

About The Position

BrightStar Care of Louisville is seeking an experienced Revenue Cycle and Billing Specialist to manage key billing, accounts receivable, payment, and payroll-related functions for its growing home care agency. The role requires an organized, persistent, detail-oriented professional who can independently research and resolve complex billing issues, particularly involving Kentucky Medicaid and managed care. The specialist is expected to take ownership of claims from initial submission through final payment. The position may begin as a part-time contract or contract-to-hire arrangement, initially approximately 15–25 hours per week, with the potential to transition to a permanent full-time internal role. Alternatively, an experienced candidate may be considered for a full-time position with broader responsibility for revenue cycle management, billing, payment processing, and payroll-related tasks. Compensation depends on experience and position structure.

Requirements

Five or more years of medical billing, revenue cycle, accounts receivable, or related experience is preferred.
Strong Medicaid and managed care billing experience.
Demonstrated experience resolving denials and recovering aged receivables.
Experience communicating directly with insurance carriers and payer representatives.
Strong analytical and problem-solving skills.
Exceptional attention to detail.
Ability to independently prioritize a large volume of outstanding accounts.
Strong Excel and reporting skills.
Ability to appropriately handle confidential financial and patient information.
Ability to communicate clearly and professionally with ACH-paying clients regarding their accounts.

Nice To Haves

Experience with Kentucky Medicaid, Passport by Molina, Anthem, Aetna Better Health, the VA, and other Kentucky Medicaid MCOs is strongly preferred.
Experience with ACH/payment processing and payroll administration is preferred.
Experience in home care, home health, private duty nursing, hospice, or other healthcare services.
Experience with Kentucky Medicaid.
Experience with Medicaid Managed Care Organizations.
Private Duty Nursing billing experience.
Electronic Visit Verification (EVV) experience.
Experience with denials and appeals.
Experience recovering aged accounts receivable.
Experience using the Availity Clearinghouse.
Payroll processing or payroll data submission experience.
ACH/client payment processing experience.

Responsibilities

Manage insurance accounts receivable from claim submission through payment.
Monitor aging accounts receivable and proactively pursue outstanding balances.
Research, correct, and resubmit denied or rejected claims.
Prepare and submit appeals and supporting documentation.
Follow up directly with insurance carriers regarding unpaid and underpaid claims.
Use payer portals, clearinghouses, and other billing systems to resolve claim issues.
Identify recurring denial trends and recommend corrective actions.
Ensure secondary claims are submitted appropriately and on time.
Maintain detailed documentation of collections and follow-up activity.
Provide regular reports on outstanding accounts receivable, collections, denials, and unresolved payer issues.
Manage billing and follow-up for Medicaid and Medicaid Managed Care claims.
Research eligibility, authorization, claim, and payment discrepancies.
Work directly with Medicaid MCOs to resolve denied or unpaid claims.
Maintain knowledge of payer requirements, billing rules, authorization requirements, and timely filing deadlines.
Assist with resolving complex or aged Medicaid receivables.
Process ACH billing and electronic client payments.
Maintain accurate payment records and reconcile payments to outstanding balances.
Research and resolve failed, returned, or incorrect ACH transactions.
Ensure payments are accurately posted to client accounts.
Maintain appropriate documentation and internal controls for payment processing.
Prepare and submit weekly payroll data accurately and on schedule.
Review payroll information for completeness and identify discrepancies before submission.
Coordinate with operations and scheduling staff to resolve payroll-related discrepancies.
Maintain accurate payroll documentation and reporting.
Assist with payroll reconciliation and correction of errors as needed.