Claims Specialist

Easterseals PORT Health • Raleigh, NC

1d

About The Position

Do you have a passion for ensuring accurate billing and helping others access
care? Easterseals PORT Health is seeking a detail-oriented Claims Specialist to
join our Revenue Cycle team. In this essential role, you will support timely
collections, improve the claims process, and help break down financial barriers
to care for those we serve. You’ll bring curiosity, follow-through, and a
collaborative mindset to make a real impact behind the scenes.

Requirements

• High School Diploma or GED required
• At least 1 year of experience working in claims, billing, or revenue cycle roles within a healthcare or behavioral health setting
• Familiarity with North Carolina LME/MCO and commercial payer guidelines
• Understanding of EOBs, insurance plans, eligibility rules, and denial codes
• Strong analytical skills and attention to detail
• Excellent verbal and written communication skills
• Ability to work independently and collaborate with cross-functional teams

Nice To Haves

• Experience using Welligent or similar EHR systems
• Knowledge of Medicaid, Medicare, commercial insurance, and behavioral health billing

Responsibilities

• Research and follow up on all outstanding balances to meet collection deadlines
• Collaborate with program staff on insurance verification, eligibility, authorizations, and claim issues
• Review and resolve denials and aged accounts, managing rejections, reconsiderations, and re-adjudications
• Identify and bill secondary/tertiary payers and submit corrected claims as needed
• Work in Welligent and other systems to support clean and complete claims
• Track trends in denials and share insights with Claims Manager
• Support program staff with reconciliation of program-related denials and unbilled services
• Assist with analytical reporting, root cause analysis, and special projects
• Provide feedback and recommendations to improve claim submissions and workflows
• Post co-pays, deductibles, co-insurance, adjustments, and transfers appropriately
• Collaborate with other departments and payers to resolve issues and ensure timely collections
• Raise concerns and share updates with the Claims Manager
• Support cross-functional efforts to improve billing processes and documentation

Benefits

• Paid time off and holidays
• Medical, Dental, and Vision plans + optional FSA
• Life and Disability Insurance
• 403(b) Retirement Plan
• Employee Assistance Program and Legal Services
• Discounts on retail, travel, and more!

What This Job Offers

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