Full-Time
340B Claims Specialist
Updated on 8/1/2026
BrightSpring Health Services
10,001+ employees
Home-based and community health services, pharmacy
No salary listed
Blanco, TX, USA
Remote
 Accounting (1) |
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- A high school diploma or GED is required.
- Customer service experience is required.
- The ability to retain a large amount of information and apply that knowledge to related situations is required.
- The ability to work in a fast-paced environment is required.
- Basic math aptitude is required.
- Proficiency with Microsoft Office Suite is required.
- Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing, eliminating financial risks.
- Research, analyze, and appropriately resolve rejected claims by working with national Medicare Part D plans, third-party insurance companies, and all state Medicaid plans while adhering to critical deadlines.
- Ensure claim approval by performing appropriate edits and reversals to maximize payer reimbursement.
- Monitor and resolve at-risk revenue associated with payer setup, billing, rebilling, and reversal processes.
- Work as part of a team to identify, document, communicate, and resolve payer and billing trends and issues.
- Review and convert billing exception reports to ensure claims are billed to accurate financial plans.
- Prepare and maintain reports and records for processing.
- Perform other assigned tasks.
- An associate’s or bachelor’s degree is desired.
- Up to one year of related experience is desired.
- Pharmacy technician experience is desired.
- Knowledge of insurance industry trends, directions, major issues, regulatory considerations, and trendsetters is desired.
- Pharmacy technician certification is desired but not required.
- Pharmacy technician experience and/or knowledge of pharmaceuticals is strongly preferred.
BrightSpring Health Services provides home and community-based health care through two main operations: Pharmacy and Provider. In Pharmacy, it offers services for patients with complex and chronic conditions, including specialty, infusion, and community pharmacy solutions. In Provider, it delivers home health, behavioral health, hospice care, and services for intellectual and developmental disabilities. The company uses an integrated care model that connects pharmacy services with in-home care across its network to support patients, families, and managed care organizations. Revenue comes from reimbursed services paid by Medicare, Medicaid, and private insurers. Its goal is to coordinate ongoing, in-home and community-based care across a continuum—from pharmacy support to direct care—ensuring coordinated, patient-centered services for individuals with complex or chronic needs.
Company Size
10,001+
Company Stage
Post IPO Equity
Headquarters
Louisville, Kentucky
Founded
1974
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Simplify's Take
What believers are saying
- Specialty pharmacy and infusion growth are driving strong revenue momentum.
- Provider expansion strengthens cross-sell and referral capture across service lines.
- Managed-care partnerships benefit from coordinated care and cost-efficiency messaging.
What critics are saying
- Medicare and Medicaid reimbursement pressure compresses margins across core service lines.
- Labor shortages and wage inflation disrupt visit coverage and raise operating costs.
- Limited-distribution drug concentration creates volatility if manufacturers revoke preferred access.
What makes BrightSpring Health Services unique
- Integrated pharmacy and provider services improve coordination for complex patients.
- Operates nationally across all 50 states with broad home-based reach.
- Serves medically complex populations through specialized, lower-cost care settings.
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Benefits
Flexible Work Hours
Growth & Insights and Company News
6 month growth
↓ -10%1 year growth
↓ -10%2 year growth
↓ -10%SEB Asset Management AB acquired a new stake in BrightSpring Health Services, Inc. (NASDAQ:BTSG – Free Report) during the first quarter, according to its most recent disclosure with the Securities & Exchange Commission. The firm acquired 341,465 shares of the company’s stock, valued at approximately $14,550,000. A number of other hedge funds have also recently […]
BrightSpring Health Services announced the resignation of Robert Barnes as President of ResCare Community Living on 30 March 2026, stating it was not due to any disagreement over operations or policies. The company's shares rose 5.2% following upbeat analyst reports from its investor day. Management unveiled ambitious long-term organic EBITDA growth targets of 15% to 20% annually through 2028, alongside AI-driven efficiency plans for its home and community-based care platform. The narrative projects $16.8 billion in revenue and $361.8 million in earnings by 2028, requiring 10.1% yearly revenue growth. Investors remain focused on whether BrightSpring can balance acquisition-driven expansion and technology investment whilst managing its substantial debt load and regulatory exposure.
BrightSpring Health Services has seen its stock price surge 43.1% over the past six months to $42.32 per share, driven by strong quarterly results. The healthcare services company, founded in 1974, offers home health care, hospice, neuro-rehabilitation and pharmacy services. BrightSpring's revenue grew at an 18.3% compound annual growth rate over the past five years, outpacing the healthcare sector average. Analysts forecast 15% revenue growth over the next 12 months, though this represents a deceleration from its recent 20.9% annual rate. However, the company's five-year average return on invested capital of 4.9% falls below the typical cost of capital for healthcare firms, suggesting historically mediocre capital efficiency. The stock currently trades at 27.7× forward price-to-earnings ratio.
BrightSpring Health Services has raised questions about its valuation after trading at 24.5 times forward earnings following strong 2025 performance. The company reported fourth-quarter revenue of $3.55 billion, up 29.3% year-over-year, with adjusted EBITDA rising 40.7% to $184 million. For 2026, management guided revenue between $14.45 billion and $15 billion, representing 11.9% to 16.2% growth, whilst adjusted EBITDA is expected to grow faster at 23% to 28%, indicating margin expansion. However, the company faces approximately $600 million in revenue headwinds from Inflation Reduction Act impacts and brand-to-generic conversions. The valuation hinges on whether BrightSpring can deliver sequential profitability improvements throughout the year despite policy and product-mix pressures affecting headline revenue growth.
BrightSpring Health Services led senior health stocks in Q4 earnings, reporting revenues of $3.55 billion, up 16.3% year on year and beating analyst expectations by 5%. The company delivered strong full-year EBITDA guidance. In contrast, Chemed posted the weakest performance, with revenues of $639.3 million falling 3% short of expectations. The company missed both revenue and full-year EPS guidance estimates, sending shares down 19.2% to $377.07. The seven senior health, home health and hospice stocks tracked reported slower Q4 results overall, with revenues beating consensus estimates by just 1.1%. Share prices have declined an average of 9.6% since earnings releases. The sector faces headwinds from labour shortages and wage inflation whilst benefiting from an ageing population and growing preference for in-home care.