Revenue Cycle and Billing Specialist

Role: Revenue Cycle & Billing Specialist

Status: Full-Time (hourly) or Contract to Hire

BrightStar Care of Louisville is seeking an experienced Revenue Cycle & Billing Specialist to take ownership of key billing, accounts receivable, payment, and payroll-related functions for our growing home care agency.

This position requires someone who is highly organized, persistent, detail-oriented, and comfortable independently researching and resolving complex billing issues. The ideal candidate will have strong experience with KY Medicaid and managed care billing and will take ownership of claims from initial submission through final payment.

This role may be structured initially as a part-time contract or contract-to-hire position for the right candidate, with the opportunity to transition into a full-time internal role.

Primary Responsibilities

Revenue Cycle Management & Accounts Receivable

• Manage insurance accounts receivable from claim submission through payment
• Monitor aging A/R 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
• Work 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 timely
• Maintain detailed documentation of collection and follow-up activity
• Provide regular reporting on outstanding A/R, collections, denials, and unresolved payer issues

Medicaid & Managed Care Billing

• 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

Experience with Kentucky Medicaid, Passport by Molina, Anthem, Aetna Better Health, VA, and other Kentucky Medicaid MCOs is strongly preferred.

ACH Billing & Payment Processing

• 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 related to payment processing

Payroll Support

• Prepare and submit weekly payroll data accurately and on schedule
• Review payroll information for completeness and identify discrepancies prior to 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

Qualifications

• 5+ years of medical billing, revenue cycle, accounts receivable, or related experience 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 handle confidential financial and patient information appropriately
• Experience with ACH/payment processing and payroll administration is preferred
• Ability to communicate clearly and professionally with ACH pay clients regarding their account

Particularly Valuable Experience

Candidates with any of the following experience are strongly encouraged to apply:

• Home care, home health, private duty nursing, hospice, or other healthcare services
• Kentucky Medicaid
• Medicaid Managed Care Organizations
• Private Duty Nursing billing
• Electronic Visit Verification (EVV)
• Denials and appeals
• Aged A/R recovery
• Use of Availity Clearinghouse
• Payroll processing or payroll data submission
• ACH/client payment processing

What Success Looks Like

The successful candidate will take genuine ownership of the revenue cycle rather than simply processing transactions.

Success in this role means:

• Claims are submitted accurately and timely
• Denials are actively worked through resolution
• Aging A/R consistently decreases
• Outstanding balances do not sit without documented follow-up
• Payments are accurately processed and reconciled
• Weekly payroll information is submitted accurately and on time
• Recurring billing problems are identified and addressed at their source
• Leadership has clear visibility into outstanding receivables and collection activity

Position Structure

We are open to considering the right candidate for either:

Contract / Contract-to-Hire: Approximately 15–25 hours per week initially, with the potential to transition into a permanent full-time position.

Full-Time: For an experienced candidate capable of assuming broader ownership of the revenue cycle, billing, payment processing, and payroll-related responsibilities.

Compensation will be based on experience and the structure of the position.