RCM AR Specialist

PORT Health; Raleigh (NC); Sur place; USD 29 000 - 32 000; Plein temps

Avantages offerts par ce poste

Generous paid time off and holidays

Medical, dental, and vision coverage +

Life and disability insurance

403(b) retirement plan

Employee Assistance Program

Professional development and training

PSLF eligibility

Résumé du poste

Easterseals PORT Health in Raleigh, NC seeks an Revenue Cycle Management Accounts Receivable Specialist to follow up on unpaid balances, denials, and aging claims. You will verify insurance, coordinate with programs, and drive timely reimbursements in a hands-on, in-person setting.

The role requires 1+ year in healthcare billing, strong analytical skills, and proficiency with Microsoft Office. Local travel and confidentiality are essential as you support our NC health services ecosystem.

Qualifications

• Requires knowledge of NC Medicaid, LME/MCO and payer billing rules.
• Minimum 1 year experience in healthcare or behavioral health billing or AR.
• Ability to analyze and interpret billing data and AR.
• Strong organizational skills and attention to detail.
• Ability to identify problems and determine root causes.
• Ability to generate ideas to improve processes across workflows.
• Professionally handle confidential information.
• Proficient in Microsoft Office (Excel/Outlook/Word/SharePoint/Teams).
• Valid NC driver's license with reliable transportation and insurance.
• Maintain confidentiality and exercise professional judgment.

Responsabilités

• Researches and follows up on outstanding balances within established timelines.
• Coordinate with program staff on insurance verification, eligibility, and authorizations.
• Communicate with funding sources regarding denials, underpayments, or outstanding claims.
• Provide root cause analysis and trend feedback to RCM Management.
• Support analytical reporting and special assignments as needed.
• Collaborate with programs to review denials and reconciliations.
• Assist in managing unbilled and violation reports.
• Perform other administrative tasks as assigned.
• Ensure all potential revenue is captured and billed.
• Identify and bill secondary/tertiary insurance and rebills.

Connaissances

Medicaid Billing Rules

Healthcare Billing

Billing Analysis

Organizational Skills

Root Cause Analysis

Process Improvement

Professionalism

Microsoft Office

Driver's License NC

Confidentiality

Formation

High School Diploma or GED

Outils

Microsoft Excel

Outlook

Word

SharePoint

Teams

Description du poste

Revenue Cycle Management Accounts Receivable Specialist

Lead with Purpose. Empower with Compassion.

Voted Raleigh’s Best Nonprofit Organization and Raleigh’s Best Mental Health Services three years in a row!

Position Snapshot Location: Raleigh, North Carolina

Schedule: Full-time | Monday – Friday | 8am-5pm

Pay: $21 – $23.50/ hour, non-exempt and over time eligible.

Work Setting: In person in our Raleigh, NC Headquarters

Position Type: Full-time

Make an Impact With Us

Do you want work that makes a meaningful difference in your community? Easterseals PORT Health is seeking a Revenue Cycle Management Accounts Receivable Specialist to join our Revenue Cycle Management (RCM) Team in Raleigh, North Carolina.

The RCM AR Specialist supports the Revenue Cycle Management (RCM) team by performing timely and accurate follow‑up on outstanding claims, denials, and unpaid balances. This role researches issues impacting payment, collaborates with internal departments and funding sources, and ensures all potential revenue is captured and billed. The AR Specialist contributes to denial management, charge entry accuracy, and resolution of aging accounts to support overall revenue cycle performance.

What You’ll Do

• Researches outstanding balances and completes required follow‑up within established timelines.
• Coordinates with program staff on insurance verification, eligibility, authorizations, and documentation needed for claim resolution.
• Communicates with funding sources regarding denied, underpaid, or outstanding claims.
• Provides ongoing root cause analysis and trend feedback to RCM Management.
• Supports analytical reporting and special assignments as requested.
• Collaborates with programs to review and reconcile program‑related denials.
• Assists programs in managing Unbilled and Violation Reports.
• Performs other administrative tasks as assigned.
• Works with programs to ensure all potential revenue is captured and billed.
• Identifies and bills secondary and tertiary insurance, including rebilled, replaced, and voided claims.
• Works in applicable systems to correct and process claims requiring adjustment or resubmission.
• Participates in root cause analysis to identify trends affecting claim submission and payment.
• Provides feedback on recurring issues impacting billing accuracy or reimbursement.
• Manages all rejections and denials, including review, reconsideration, and resolution.
• Reviews and resolves aging accounts.
• Posts co‑pays, deductibles, co‑insurance, and claim adjustments.
• Resolves claim issues related to re‑adjudications, transfers, recoupments, voids, and retro‑Medicaid rebills.

What You Bring

• High School Diploma or GED required.
• Knowledge of North Carolina Medicaid, LME/MCO, and commercial payer billing rules and regulations.
• Minimum of one (1) year of experience in healthcare or behavioral health billing, claims processing, or accounts receivable.
• Ability to analyze and interpret issues in billing, data collection, and accounts receivable.
• Strong organizational skills and attention to detail.
• Ability to identify problems, gather relevant information, and determine root causes.
• Ability to generate ideas that improve processes and identify connections across workflows.
• Demonstrated professionalism and ability to handle confidential information appropriately.
• Valid unrestricted North Carolina driver’s license, reliable transportation, and current vehicle insurance.
• Proficiency in Microsoft Office Suite, including Excel, Outlook, Word, SharePoint, and Teams.
• Ability to maintain confidentiality and exercise professional judgment.

Why Join Easterseals PORT Health?

Easterseals PORT Health is a trusted and compassionate organization providing disability, mental health, and substance use services across North Carolina and Virginia. Purpose, dedication, and empathy guide the way we support our neighbors and one another.

For Benefits-eligible Positions, Our Total Rewards Package May Include

• Generous paid time off and holidays
• Medical, dental, and vision coverage + FSA
• Life and disability insurance
• 403(b) retirement plan
• Employee Assistance Program and legal services
• Professional development and training opportunities, including AHEC where applicable
• Public Service Loan Forgiveness (PSLF) eligibility where applicable

About Easterseals PORT Health

Easterseals PORT Health helps people with disabilities, mental health and/or substance use challenges, their families, and our employees embrace their potential, access opportunities, build resilience and thrive. Purpose, dedication, and empathy drive our in-person and telehealth service delivery.

Our 2,800-member team provides more than 10.2 million hours of meaningful support to 40,200 children, adults, and families in 11,000 home, facility, and community locations across North Carolina and Virginia.

Easterseals PORT Health is an Inclusive Culture, Different Voices, Embracing Potential, Authentic Self, and Learning and Growing.