NewRevenue Cycle Manager Ultimate Staffing ServicesRevenue Cycle ManagerRaleigh, North Carolina$95,000–$115,000This is a highly visible leadership role where you'll partner with executive leadership, manage vendor relationships, analyze key performance metrics, and drive initiatives that strengthen revenue cycle outcomes. We're seeking an experienced Revenue Cycle Manager to oversee the financial performance, compliance, and operational effectiveness of our revenue cycle function.
Epic Denials Management Operator DeloitteEpic Denials Management OperatorRaleigh, NC$70,000–$90,000 / yearJoin Deloitte's AI & Engineering practice to support hospital denials management to deliver back-end Revenue Cycle Management (RCM) services, including Billing and Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes.
Epic Denials Management Coordinator DeloitteEpic Denials Management CoordinatorRaleigh, NC$50,000–$60,000 / yearJoin Deloitte's AI & Engineering practice to support hospital denials management to deliver back-end Revenue Cycle Management (RCM) services, including Billing and Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes.
Manager, Revenue Integrity *hybrid* WakeMed Health & HospitalsManager, Revenue Integrity *hybrid*Raleigh, NC3 Years Leadership Required 1 Year Project Management Required 5 Years Healthcare Required 7 Years Health Information Management Preferred 7 Years Accounting/Finance - Revenue Cycle Preferred. By partnering with clinical, operational, and financial leaders, the Manager drives process improvements that enhance revenue cycle performance and support the organization's financial health.
Utilization Manager Behavioral Health Duke UniversityUtilization Manager Behavioral HealthDurham, NCWorks collaboratively with physicians, staff and service line leadership on quality and performance improvement activities related to optimal utilization of resources, efficient delivery of high quality care, patient flow, capacity management and other clinical cost reduction Utilization Manager Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with regulatory or payor-specific guidelines for all short-stay Medicare inpatients and outpatients (DUH), all observation encounters, all combined/segmental billing encounter questions, and any encounter sent to the UM MCA from PRMO for patient status/post-bill medical necessity denials/coding questions. With 388 beds it is the second largest of Duke Healths four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, womens services, and heart and vascular services.
Utilization Manager Duke UniversityUtilization ManagerDurham, NCWorks collaboratively with physicians, staff and service line leadership on quality and performance improvement activities related to optimal utilization of resources, efficient delivery of high quality care, patient flow, capacity management and other clinical cost reduction Utilization Manager Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with regulatory or payor-specific guidelines for all short-stay Medicare inpatients and outpatients (DUH), all observation encounters, all combined/segmental billing encounter questions, and any encounter sent to the UM MCA from PRMO for patient status/post-bill medical necessity denials/coding questions. Supports denials management by documenting activities related to denials adjudication according to departmental guidelines and actively works to overturn threatened denial activities.
Charge Capture Analyst *hybrid* WakeMed Health & HospitalsCharge Capture Analyst *hybrid*Raleigh, NCWorks with Revenue Cycle, Finance, and clinical departments to analyze coding and billing processes to ensure accurate and optimal revenue capture by developing trending, modeling, and other assessment tools. The Charge Capture Analyst is responsible for the analytics to identify opportunities, problem resolutions, process improvements, and system changes to enhance revenue cycle metrics.
Revenue Cycle Representative Senior - Customer Service Call Center UNC HealthRevenue Cycle Representative Senior - Customer Service Call CenterChapel Hill, NC$19.98–$28.54 / hourThis position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job. Responsibilities: Appeals & Managed Care Escalations: Project Manage all 3rd party appeals including researching and determining if carrier denial of claim is valid and if not, abstracts information from medical records to support appeal of denial.
Epic Denials Management Coordinator Deloitte Touche Tohmatsu LtdEpic Denials Management CoordinatorRaleigh, NC$50,000–$60,000 / yearJoin Deloitte's AI & Engineering practice to support hospital denials management to deliver back-end Revenue Cycle Management (RCM) services, including Billing and Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes.
Epic Denials Management Operator Deloitte Touche Tohmatsu LtdEpic Denials Management OperatorRaleigh, NC$70,000–$90,000 / yearJoin Deloitte's AI & Engineering practice to support hospital denials management to deliver back-end Revenue Cycle Management (RCM) services, including Billing and Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes.
High Dollar Review Specialist Brighton Health Plan Solutions, LLCHigh Dollar Review SpecialistChapel Hill, NCRemoteFull timeBrighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives.
Business Integration Specialist- Mid Level Expert Technology ServicesBusiness Integration Specialist- Mid LevelRaleigh, NCServe as the primary lead for QPHE's project leveraging NC HealthConnex for quality and population health, including final project design and future strategy development. - Cultivate and manage relationships with key stakeholders, including state agencies, Medicaid experts, analysts, technology experts, and vendors.
Medicare Pricing Analyst Wisconsin Physicians Service Insurance CorpMedicare Pricing AnalystNCRemoteThe Medicare Pricing Procedures Analyst also researches and responds to interdepartmental requests, reviews Medicare pricing guidance, supports system testing and validation, maintains internal documentation, and assists the Technical Claims team with projects that improve the accuracy and efficiency of Medicare pricing operations. This role supports the implementation and validation of CMS pricing updates, maintains pricing information within Medicare systems, and collaborates with CMS, Shared System Maintainers, and other Medicare Administrative Contractors (MACs) to ensure accurate and timely claims payment.
Financial Care Counselor - Drah Ptot (Knightdale) Duke UniversityFinancial Care Counselor - Drah Ptot (Knightdale)Raleigh, NCAccurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
Financial Care Counselor - Pt/Ot (N Duke Street) Duke UniversityFinancial Care Counselor - Pt/Ot (N Duke Street)Durham, NCAccurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
NewFinancial Care Counselor - DUH Perioperative Services Duke UniversityFinancial Care Counselor - DUH Perioperative ServicesDurham, NCAccurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
NewFinancial Care Counselor - DRH ED Duke UniversityFinancial Care Counselor - DRH EDDurham, NCAccurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
Financial Care Counselor - Duke Health Center - Pickens Duke UniversityFinancial Care Counselor - Duke Health Center - PickensDurham, NCAccurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
Financial Care Counselor - Cancer Center Financial Care Duke UniversityFinancial Care Counselor - Cancer Center Financial CareDurham, NCAccurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.
Financial Care Counselor - Ancillary Service Access (Float Position) Duke UniversityFinancial Care Counselor - Ancillary Service Access (Float Position)Durham, NCAccurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle.