RCM AR Specialist
Raleigh, NC, United States4h ago
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Key details
- Salary
- $44K–$49K/yr
- Location
- Raleigh, NC, United States
- Work style
- Onsite
- Level
- Mid level
- Job type
- Full-time
- Experience
- 3–6 yrs
- Function
- Operations & Strategy
- Focus area
- other
- Posted
- 4h ago
Skills
About the role
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
We’re looking for someone who brings the experience, skills, and commitment needed to succeed in this role.
- 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.
Applicants of all abilities are encouraged to apply! Need assistance with the application process or an accommodation? Contact recruiter@eastersealsPORT.com.