Manage an assigned book of business, including billing, collections, appeals, denials, and claim follow-up.
Process Workers’ Compensation and Personal Injury prescription claims.
Review aging reports and conduct timely follow-up on unpaid, underpaid, and outstanding claims.
Investigate claim denials, payment adjustments, notices of disallowance, and other reimbursement issues, and take appropriate action to obtain reimbursement.
Prepare and submit appeals, reconsiderations, and disputes with the required supporting documentation.
Lead and manage all day-to-day Revenue Cycle Management operations, ensuring accuracy, efficiency, and compliance across billing, posting, collections, denials, and reporting.
Responsibilities
Oversee all RCM operations: billing, posting, collections, denials, and reporting
Manage supervisors and frontline staff across multi-functional RCM teams
Monitor essential KPIs such as denial rate, DSO, charge lag, clean claim rate, and collection targets
Lead daily/weekly reviews to ensure timely submissions, postings, and follow-up workflows
Ensure alignment with payer requirements and organizational goals
The Epic PB Claims Application Architect leads the design, development, optimization, and long-term strategic direction of Epic Professional Billing (PB) Claims and related Revenue Cycle applications. This role provides technical expertise, architectural oversight, and strategic guidance to ensure solutions align with business objectives, operational needs, and organizational goals.
Responsibilities
Oversee Epic PB Claims system configurations, application architecture, module development, and overall system health.
Serve as the primary subject matter expert and trusted advisor for Epic Professional Billing Claims and related Revenue Cycle applications.
Collaborate with cross-functional teams, operational leaders, stakeholders, and vendors to evaluate business needs and design effective technical solutions.
Lead architecture, design, build strategy, workflow development, system enhancements, monitoring, troubleshooting, testing, and validation activities.
Serve as project lead for strategic Epic PB Claims initiatives, upgrades, optimizations, and enterprise-wide system enhancements.
Provides accurate and timely submission of claims for Prisma Health, follows up on specialty accounts, resolves denials, and ensures correct payment posting.
Responsible for the billing, follow-up and collection of Medical Center receivables in order to maintain positive cash flow and reduce accounts receivable and A/R days, in compliance with all applicable regulations.
Compensation
The pay range for this position is $20.00 - $25.00/hr.
Responsible for the billing, follow-up and collection of Medical Center receivables in order to maintain positive cash flow and reduce accounts receivable and A/R days, in compliance with all applicable regulations.
Locations (2)
Raleigh, North Carolina, United States
United States
Compensation
The pay range for this position is $20.00 - $25.00/hr.
Oversee day-to-day clinic operations, staff coordination, process improvement, training, and administrative duties such as billing and patient inquiries.
Responsibilities
Optimize clinic operations including patient registration, billing, demographics, code scanning, denials, and collections
Oversee staff scheduling, onboarding, and education
Assist with payroll, timekeeping, and performance management
Respond to patient inquiries and address issues to improve clinic flow
Lead meetings and huddles ensuring adherence to safety, infection control, and departmental policies
The Senior Patient Access Specialist is responsible for performing admitting duties for all patients admitted for services at the hospital, including assigning MRNs, medical necessity checks, and collecting insurance information.
Compensation
This position pays between $18.65 - $19.90/hr. based on experience
Responsibilities
Perform admitting duties for all patients admitted for services at the hospital
Assign accurate MRNs
Complete medical necessity / compliance checks
Provide proper patient instructions
Collect insurance information
Requirements
Associates Degree
Healthcare administration
Business administration
Nice to have: Certified Healthcare Access Associate (CHAA)
Nice to have: Certified Revenue Cycle Representative (CRCR)
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