Revenue Cycle Management (RCM) – Senior Specialist

Job Openings: Revenue Cycle Management (RCM) – Senior Specialists (5 Openings)
Location: Raleigh, NC (Hybrid in NC; remote for other states with occasional client-site travel covered by the client)
Type: Contract / Full-Time (C2C)
Engagement: Enterprise Healthcare & Laboratory Revenue Cycle Modernization
We are hiring senior-level RCM specialists across multiple tracks. When applying, specify your primary focus:
1. Functional SME – Order-to-Cash: End-to-end lab/clinical lifecycle from CPOE, eligibility, auth, medical necessity, and compendium pricing to charge capture, claims, denials, and cash posting.
2. Functional SME – Payer Systems: Claim-to-Cash analysis, EDI 837P/837I, 835 ERA, clearinghouse edits, payer adjudication, CARC/RARC mapping, COB, and remit reconciliation.
3. Techno-Functional SME – Core Platform: Mapping RCM data flows across legacy architectures including Gen/CoolGen, COBOL, CICS, DB2, IMS/IDMS, VSAM, JCL batch, and extracts.
4. Process Design Architect: Enterprise RCM operational redesign, work queue optimization, denial prevention controls, handoff governance, and measurable SLA improvements.
5. RCM Business Analyst: Discovery, process mapping, requirements traceability (RTM), SQL data profiling, interface/RPA inventorying, and MVP backlog definition.
Qualifications:
8+ years of dedicated Healthcare RCM, Laboratory Billing, or Payer Systems experience.
Demonstrated hands-on technical or functional mastery aligned directly with your chosen track.

Work arrangement
Yes