Revenue Cycle Specialist (4441)

ncgCARE; Raleigh (NC); On-site; USD 26,000 - 33,000; Full time

Benefits offered by this job

Health plan (Anthem)

HSA/FSA

Dental plan (Delta Dental)

Vision plan (EyeMed)

401k/IRA

Educational Assistance

Licensure Residency Program

Career development

Job summary

ncgCARE is seeking a Revenue Specialist to join the Revenue Operations team in Raleigh, NC. You will review and validate claim information, correct billing errors, and analyze denials to improve accuracy and cash flow.

You will collaborate with billing, IT, and payers, support credentialing and records management, and contribute to process improvements while ensuring HIPAA privacy and compliance in an in-office role.

Qualifications

• Denial management knowledge and experience with claim denials.
• 1-3 years in healthcare revenue operations, billing, or claims processing preferred.
• Bachelor's Degree (preferred).

Responsibilities

• Review and correct claims to ensure accurate billing and timely payments.
• Investigate claim denials and work with insurance payers to resolve issues.
• Manage credentialing, medical records, and compliance–related documentation.
• Collaborate with team members to improve revenue processes and support daily operations.

Skills

Denial management

Payer outreach

Claims review

Education

Bachelor's Degree (preferred)

Job description

Job Details: Level: Entry, Job Location: Raleigh, NC 27604, Position Type: Full Time, Education Level: High School or High School Equivalent, Salary Range: $18.93 - $24.30 Hourly, Travel Percentage: None, Job Category: Admin - Clerical, About Us

About Us

Established in 1993, ncgCARE is the proud parent of a diverse network of seven behavioral healthcare organizations specializing in outpatient counseling, community-based counseling, and treatment foster care.

Through our network of providers, ncgCARE is leading the way to excellence in behavioral healthcare. We provide the foundation for our provider partners to succeed through innovation, service excellence, best practice development, and a strong commitment to our employees.

About the Role

The Revenue Specialist plays a crucial role in the Revenue Operations team, reporting directly to the Revenue Operations Supervisor. This involves actively reviewing and validating claim information, promptly correcting billing errors to maintain data precision, analyzing denied claims to identify reasons for denial, and implementing workflow and procedural enhancements to minimize denials. The role also includes collaborating with the billing team to address claim submission discrepancies, contributing to denial management efforts, actively participating in revenue optimization initiatives, and fostering close teamwork for a cohesive and cooperative approach to achieving optimal financial performance.

This position is NOT remote - this is an In-Office position.

The role encompasses information management, including record management, subpoena response, and credentialing responsibilities. This involves both new and re-credentialing processes.

• Denial Management: Analyze denied claims to identify reasons for denial. Promptly correct billing errors to maintain data precision.
• Payer Outreach: Contacting payers to gather information on claim denials.
• Process Improvement: Assist with implementing revenue-related processes and strategies to enhance operational efficiency.
• Collaboration: Collaborating with partner leadership, corporate leadership, the billing team, IT, and payers to resolve issues.
• Credentialing: Collaborate with relevant partner-level staff to collect, submit, and/or verify required credentials. Initiate credentialing and re-credentialing processes for applicable clinical staff and maintain working status.
• Information Management: Facilitate the release of medical records to authorized personnel, including clients, healthcare facilities, and insurance companies. Respond to subpoenas and court orders, ensuring accurate coordination and legal compliance. Uphold the highest standards of privacy, security, and legal requirements, particularly within the scope of HIPAA.
• Facility: Support facility licensing and enrollment process.
• Contracts: Support the contract management process.
• Teamwork: Foster close teamwork for a cohesive and cooperative approach to achieving optimal financial performance.
• Reporting: Contribute to regular reporting on key performance indicators (KPIs) related to revenue processes.
• Meetings: Attend and actively contribute to staff meetings within the Revenue Operations team.
• Training: Attend relevant training to stay updated on industry best practices, regulatory changes, and emerging trends.

Compensation

Competitive hourly pay aligned with your role, experience, and contribution, with opportunities for growth over time.

Placement within the range is based on licensure level, education, and experience.

Compensation: $18.93 - $24.30

What You Can Expect

• Review claims, fix billing issues, and help reduce claim denials.
• Work with insurance payers, billing teams, and staff to solve problems and improve processes.
• Support credentialing, medical records, licensing, and other revenue operations tasks.
• Be part of a collaborative in-office team focused on accuracy, compliance and excellent service.

Responsibilities

• Review and correct claims to ensure accurate billing and timely payments.
• Investigate claim denials and work with insurance payers to resolve issues.
• Manage credentialing, medical records, and compliance–related documentation.
• Collaborate with team members to improve revenue processes and support daily operations.

Qualifications: Education

• Bachelor's Degree (preferred)

Experience

• Basic knowledge of denial management processes is required.
• 1-3 years of experience in a similar role within healthcare revenue operations, billing, or claims processing is preferred.

Why Join Us

We are focused on creating a model where clinicians are supported, not overloaded. You’ll have the flexibility to shape your schedule, the support to maintain a steady caseload, and the opportunity to grow within a stable, mission-driven organization.

Beyond the engaging work, you'll also benefit from our competitive benefits package to support you and your loved ones, provide work/life balance, and invest in your future. The list below is for informational purposes only.

• Consumer-driven health plan coverage provided by Anthem
• Wellness: When you enroll in a medical plan, you get complete care support on your time through Sydney app (Anthem), with exclusive access to 24/7 access to licensed doctors, therapists, and psychiatrists.
• Health Savings Account (HSA) or Flex Spending Account (FSA)
• Two dental plan options available through Delta Dental, so you can choose the level of coverage that fits your needs and budget.
• Affordable vision plan available through EyeMed to keep your eyes healthy and your vision sharp.
• An optional Dependent Care Flexible Spending Account to reimburse yourself on a pre-tax basis for childcare.
• Generous paid time off
• 401k or Roth IRA Retirement Programs administered by Empower
• Financial planning and education services at no cost to you
• Voluntary supplemental benefits (Accident, Critical Illness, Short-Term Disability)
• Educational Assistance (your position, date of hire and years of service determine your eligibility)
• Licensure Residency Program for Full-time Clinical Staff
• Advancement and Career Development Opportunities

Legal Notice

We are an equal opportunity employer. Employment is at-will and contingent upon successful completion of background checks and credential verification. We participate in E-Verify to confirm employment eligibility in the United States. Reasonable accommodations are available upon request in accordance with the Americans with Disabilities Act (ADA). Must be authorized to work in the United States. Compensation varies based on licensure, experience, and caseload. ncgCARE and all partner affiliates maintain a drug-free workplace.