Health Payer Escalated Contract and Billing Specialist
BrightSpring Health Services
### Experience Required
None
### Minimum Education Required
High School Diploma/G.E.D.
### Compensation
$7.25 / hourly
### Hours Per Week
40
### Number Of Positions
1
### Work Schedule and Shift Requirements
First (Day)
### Job Description
Requisition: 2026-193342
Health Payer Escalated Contract and Billing Specialist
Job Locations
US-KY-LOUISVILLE
ID 2026-193342 Line of Business BrightSpring Health Services Position Type Full-Time
Our Company
BrightSpring Health Services
Overview
Key responsibilities include ability to interpret complex health insurance contracts, understand billing processes, and effectively communicate and resolve escalated payment issues with insurance carriers working within the billing and contracting teams.
Responsibilities
Contract & Benefit Interpretation: Review and apply health insurance contracts to billable services, benefit policy terms, and coverage limitations to determine eligibility and payment eligibility for claims per contract expectations according to benefit parameters.
Demonstrate billing process expertise to identify and address escalated payment issues as a result of internal billing discrepancies.
Investigate and resolve escalated payment disputes, including denied, underpaid, or delayed claims, by coordinating with health insurance contract stakeholders as well as internal stakeholders.
Build data-driven cases to support, justify, and advocate for escalated claims payments.
Able to review claims submission for internal errors creating escalated payment issues and communicating those details
Qualifications
Bachelor's degree in related field preferred
Experience or strong understanding in contracting & contract management
Experience in medical or insurance billing with a track record of resolving escalated payment issues.
Proficiency in billing software, EHR systems, and claims submission platforms.
Experience of or strong understanding of ICD-10, CPT, modifiers, and insurance payment terms.
Experience with MPPR/Sequestration, coinsurance and Deductibles
Coding Certification a plus
Excellent time management, prioritization and organizational skills
Experience in Outlook, Word, and PowerPoint desired
Detail-oriented with strong organizational and problem-solving abilities
Self-motivated and results oriented
Proficiency in Microsoft Office applications, including Excel, Word and PowerPoint
Excellent verbal and written communication and presentation skills
Mininmal travel
About our Line of Business
BrightSpring Health Services provides complementary home- and community-based health solutions for complex populations in need of specialized and/or chronic care. Through the Company's service lines, including pharmacy, home health care, and rehabilitation, we provide comprehensive and more integrated care and clinical solutions in all 50 states to over 475,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and industry-leading quality metrics across its services lines, while improving the health and quality of life for high-need individuals and reducing overall healthcare system costs.For more information, please visit www.brightspringhealth.com. Follow us on Facebook, LinkedIn, and X.
Res-Care, Inc., dba BrightSpring Health Services (“ResCare”), is an Equal Opportunity Employer. ResCare does not discriminate against any person on the basis of gender, r ace, color, national origin, r eligion, disability, age, veteran status, gender identity or s exual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.
### Job Type
Full time
### Benefits Offered
Not specified
### Veteran Preference
No
### Place of Work
On-site
### Requisition ID
2026-193342
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