Revenue Integrity Billing Readiness Specialist

BrightSpring Health Services; Nashville (TN); On-site; USD 48,000 - 64,000; Full time

Job summary

BrightSpring Health Services is seeking a Billing Readiness Specialist in Nashville to ensure patient accounts are properly configured before billing and treatment. You will bridge intake, authorization, and billing to support clean claim submission and timely reimbursement.

The role emphasizes verifying insurance setup, payer plan selection, benefit verification, and patient financial responsibility while preventing denials and ensuring accurate claim routing.

Qualifications

• High School Diploma or GED required.
• 3+ years of experience in medical billing, insurance verification, authorizations, or healthcare revenue cycle required.
• Experience with Medicare, commercial insurance, and managed care preferred.
• Outpatient therapy experience preferred.
• Experience in medical billing, insurance verification, healthcare revenue cycle, or related healthcare operations preferred.
• Knowledge of insurance eligibility, benefit verification, and payer requirements.
• Understanding of authorization workflows and reimbursement processes.
• Familiarity with outpatient therapy billing workflows preferred.

Responsibilities

• Verify active insurance coverage and eligibility.
• Validate accurate payer and plan selection within the practice management system.
• Confirm subscriber/member demographic accuracy.
• Review coordination of benefits and secondary insurance information.
• Ensure payer setup aligns with discipline-specific billing requirements.
• Verify patient financial responsibility including copays, coinsurance, and deductibles.
• Review authorization status, visit counts, and CPT code alignment.
• Identify missing, incomplete, or expired authorizations.
• Perform pre-billing account audits to identify issues impacting reimbursement.
• Communicate account discrepancies and payer concerns to clinics and billing staff.

Skills

3+ years experience

Insurance eligibility

Payer requirements

Communication skills

EMR proficiency

Education

High School Diploma or GED

Associate degree preferred

Tools

EMR systems

Practice management systems

Job description

BrightSpring Health Services is seeking a Billing Readiness Specialist in Nashville to ensure patient accounts are properly configured before billing and treatment. You will bridge intake, authorization, and billing to support clean claim submission and timely reimbursement.

The role emphasizes verifying insurance setup, payer plan selection, benefit verification, and patient financial responsibility while preventing denials and ensuring accurate claim routing.