RCM AR 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!

• →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.

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.

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.