RCM AR Specialist

Easterseals PORT Health • Raleigh, NC

5d • $21 - $24 • Onsite

About The Position

Easterseals PORT Health is seeking a Revenue Cycle Management Accounts Receivable Specialist to join its Revenue Cycle Management team at its Raleigh, North Carolina headquarters. This in-person role supports timely and accurate follow-up on outstanding claims, denials, and unpaid balances. The specialist researches payment issues, works with internal departments and funding sources, and helps ensure potential revenue is captured and billed. The role also contributes to denial management, charge-entry accuracy, and resolution of aging accounts to support revenue cycle performance.

Requirements

• High school diploma or GED.
• Knowledge of North Carolina Medicaid, LME/MCO, and commercial payer billing rules and regulations.
• At least one 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 process-improvement ideas and identify connections across workflows.
• 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.

Nice To Haves

• Professional development and training opportunities, including AHEC where applicable, are offered as part of the rewards package; these are not stated as candidate qualifications.

Responsibilities

• Research outstanding balances and complete required follow-up within established timelines.
• Coordinate with program staff on insurance verification, eligibility, authorizations, and documentation needed to resolve claims.
• Communicate with funding sources regarding denied, underpaid, or outstanding claims.
• Provide root-cause analysis and trend feedback to RCM management.
• Support analytical reporting and special assignments as requested.
• Collaborate with programs to review and reconcile program-related denials.
• Assist programs in managing Unbilled and Violation Reports.
• Perform other administrative tasks as assigned.
• Work with programs to ensure potential revenue is captured and billed.
• Identify and bill secondary and tertiary insurance, including rebilled, replaced, and voided claims.
• Use applicable systems to correct and process claims requiring adjustment or resubmission.
• Participate in root-cause analysis to identify trends affecting claim submission and payment.
• Provide feedback on recurring issues affecting billing accuracy or reimbursement.
• Manage rejections and denials, including review, reconsideration, and resolution.
• Review and resolve aging accounts.
• Post co-pays, deductibles, co-insurance, and claim adjustments.
• Resolve claim issues related to re-adjudications, transfers, recoupments, voids, and retro-Medicaid rebills.

Benefits

• Generous paid time off and holidays.
• Medical, dental, and vision coverage, plus a flexible spending account (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 eligibility where applicable.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED