Case Manager Adult Transplant
Durham, NC · On-site
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Case Manager Adult Transplant
Durham, NC · On-site
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Medical Field Case Manager
Raleigh, NC · On-site
$70K - $80K/yr
... reimbursement, Employee Assistance and Referral Program, and hands-on workers' compensation case management training. Join our compassionate team and help make a positive difference in an injured ...
Medical Field Case Manager
Raleigh, NC · On-site
$70K - $80K/yr
... reimbursement, Employee Assistance and Referral Program, and hands-on workers' compensation case management training. Join our compassionate team and help make a positive difference in an injured ...
Medical Field Case Manager
$70K - $80K/yr
... reimbursement, Employee Assistance and Referral Program, and hands-on workers' compensation case management training. Join our compassionate team and help make a positive difference in an injured ...
Medical Field Case Manager
$70K - $80K/yr
... reimbursement, Employee Assistance and Referral Program, and hands-on workers' compensation case management training. Join our compassionate team and help make a positive difference in an injured ...
Field Nurse Case Manager Paradigm is an accountable specialty care management organization focused ... phone and internet reimbursement, mileage reimbursement (federal rate), 401(k) matching ...
Field Nurse Case Manager Paradigm is an accountable specialty care management organization focused ... phone and internet reimbursement, mileage reimbursement (federal rate), 401(k) matching ...
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
Case Manager PRN
Durham, NC · On-site
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
Case Manager PRN
Durham, NC · On-site
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
Case Manager PRN
Durham, NC · On-site
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
Case Manager PRN
Durham, NC · On-site
... and reimbursement guidelines, the discharge planning process and applicable federal, state and ... NC) CASE MANAGER Job Level: G2 Duke is an Equal Opportunity Employer committed to providing ...
Case Manager NEX-PRN
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Maintains working knowledge of payer and reimbursement practices impacting the plan of care ... Case Management experience Computer skills (basic) Works in a continually changing work environment ...
Case Manager NEX-PRN
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Maintains working knowledge of payer and reimbursement practices impacting the plan of care ... Case Management experience Computer skills (basic) Works in a continually changing work environment ...
RN Hospice Case Manager
Franklinton, NC · On-site
$84K - $86K/yr
Overview Hospice RN Case Manager Make a difference every day as an Amedisys RN case manager Join ... Fleet vehicle program (restrictions apply) and mileage reimbursement. * And more. *Benefit ...
RN Hospice Case Manager
Franklinton, NC · On-site
$84K - $86K/yr
Overview Hospice RN Case Manager Make a difference every day as an Amedisys RN case manager Join ... Fleet vehicle program (restrictions apply) and mileage reimbursement. * And more. *Benefit ...
RN Case Manager - Cardiothoracic Surgery
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Maintains working knowledge of payer and reimbursement practices impacting the plan of care ... Case Management experience Computer skills (basic) Works in a continually changing work environment ...
RN Case Manager - Cardiothoracic Surgery
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Maintains working knowledge of payer and reimbursement practices impacting the plan of care ... Case Management experience Computer skills (basic) Works in a continually changing work environment ...
RN Case Manager - Cardiothoracic Surgery
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Maintains working knowledge of payer and reimbursement practices impacting the plan of care ... Case Management experience Computer skills (basic) Works in a continually changing work environment ...
RN Case Manager - Cardiothoracic Surgery
Wake Forest, NC · On-site
$38.20 - $57.30/hr
Maintains working knowledge of payer and reimbursement practices impacting the plan of care ... Case Management experience Computer skills (basic) Works in a continually changing work environment ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Re-entry Case Manager NIABH
Raleigh, NC · On-site
$19.50 - $25/hr
Tuition Reimbursement * Career Advancement Opportunities and Growth * Flexible Schedules ... Responsibilities The Re-Entry Case Manager works with individuals housed in the Wake County ...
Quick apply
Re-entry Case Manager NIABH
Raleigh, NC · On-site
$19.50 - $25/hr
Tuition Reimbursement * Career Advancement Opportunities and Growth * Flexible Schedules ... Responsibilities The Re-Entry Case Manager works with individuals housed in the Wake County ...
Re-entry Case Manager NIABH
Raleigh, NC · On-site
$19.50 - $25/hr
Tuition Reimbursement * Career Advancement Opportunities and Growth * Flexible Schedules ... The Re-Entry Case Manager divides their time between the detention center and the community ...
Quick apply
Re-entry Case Manager NIABH
Raleigh, NC · On-site
$19.50 - $25/hr
Tuition Reimbursement * Career Advancement Opportunities and Growth * Flexible Schedules ... The Re-Entry Case Manager divides their time between the detention center and the community ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Provide education to patients, families, and care teams regarding benefits, reimbursement ... Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire * For BSN ...
Re-entry Case Manager NIABH
Raleigh, NC · On-site
$19.50 - $25/hr
Tuition Reimbursement * Career Advancement Opportunities and Growth * Flexible Schedules * Retirement Savings Plan Join us and be a part of something bigger. Apply today. The Re-Entry Case Manager ...
Re-entry Case Manager NIABH
Raleigh, NC · On-site
$19.50 - $25/hr
Tuition Reimbursement * Career Advancement Opportunities and Growth * Flexible Schedules * Retirement Savings Plan Join us and be a part of something bigger. Apply today. The Re-Entry Case Manager ...
Reimbursement Case Manager information
See Raleigh, NC salary details
$14.02 - $16.50
6% of jobs
$18.83 is the 25th percentile. Wages below this are outliers.
$16.50 - $18.99
20% of jobs
The median wage is $21.32 / hr.
$18.99 - $21.48
25% of jobs
$21.48 - $23.96
21% of jobs
$24.58 is the 75th percentile. Wages above this are outliers.
$23.96 - $26.45
9% of jobs
$26.45 - $28.93
5% of jobs
$28.93 - $31.42
4% of jobs
$31.42 - $33.90
3% of jobs
$33.90 - $36.39
2% of jobs
$36.39 - $38.87
2% of jobs
$38.87 - $41.36
1% of jobs
$14
$24
$41
How much do reimbursement case manager jobs pay per hour?
As of Sep 2, 2026, the average hourly pay for reimbursement case manager in Raleigh, NC is $24.06, according to ZipRecruiter salary data. Most workers in this role earn between $18.70 and $26.15 per hour, depending on experience, location, and employer.
What are the key skills and qualifications needed to thrive as a reimbursement case manager?
To thrive as a Reimbursement Case Manager, you need a solid understanding of healthcare reimbursement processes, insurance policies, and medical billing, often supported by a background in nursing, social work, or healthcare administration. Familiarity with claims management systems, electronic health records (EHRs), and payer portals is typically required, and certifications like CCM (Certified Case Manager) can be advantageous. Strong communication, problem-solving, and organizational skills help you effectively advocate for patients and collaborate with providers and payers. These competencies ensure accurate reimbursement, compliance, and optimal patient outcomes in a complex healthcare environment.
How does a reimbursement case manager typically collaborate with healthcare providers and insurance companies to resolve patient billing issues?
Reimbursement Case Managers act as key liaisons between healthcare providers, patients, and insurance companies to ensure that claims are processed accurately and efficiently. They regularly communicate with medical staff to collect necessary documentation, clarify coding, and verify treatment details. Additionally, they work closely with insurance representatives to address denials, appeal decisions, and troubleshoot payment delays. This collaborative approach requires strong communication skills and a deep understanding of both clinical and insurance processes.
What is the difference between Reimbursement Case Manager vs Claims Specialist?
| Aspect | Reimbursement Case Manager | Claims Specialist |
|---|---|---|
| Credentials | Typically requires healthcare or insurance-related certifications | Often requires insurance or claims processing certifications |
| Work Environment | Healthcare facilities, insurance companies, or managed care organizations | Insurance companies, third-party administrators, or healthcare providers |
| Job Focus | Managing reimbursement processes, verifying coverage, and resolving billing issues | Processing claims, reviewing documentation, and ensuring accurate claim submission |
Reimbursement Case Managers and Claims Specialists both work within the healthcare and insurance industries, focusing on financial aspects of patient care. While Reimbursement Case Managers primarily handle reimbursement processes and coverage verification, Claims Specialists concentrate on processing and reviewing insurance claims. Both roles require knowledge of insurance policies and healthcare billing, but their daily tasks and focus areas differ slightly.
What does a reimbursement case manager do?
A reimbursement case manager reviews and processes insurance claims and reimbursement requests, ensuring accuracy and compliance with policies. They communicate with clients, healthcare providers, and insurance companies, often using case management software, to resolve issues and facilitate timely payments.
What are popular job titles related to Reimbursement Case Manager jobs in Raleigh, NC?
For Reimbursement Case Manager jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Reimbursement Case Manager jobs in Raleigh, NC look for?
The top searched job categories for Reimbursement Case Manager jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Reimbursement Case Manager jobs?
Cities near Raleigh, NC with the most Reimbursement Case Manager job openings:
Duke Health rating
7.2
Based on 256 frontline employees who took The Breakroom Quiz
345th of 898 rated healthcare providers
Job description
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke University Hospital
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
Duke Nursing Highlights:
Inpatient Case Management or Transplant experience and NC LCSW License Highly Preferred
The Case Manager is responsible for managing an assigned caseload to ensure timely assessment, planning, implementation, and evaluation of discharge plans and care transitions across the continuum of care. This role supports optimal patient outcomes, effective resource utilization, and compliance with CMS and other regulatory agencies. The Case Manager collaborates closely with interdisciplinary teams, patients, families, and community partners to coordinate safe, efficient care transitions.
Key Responsibilities
Care Coordination & Discharge Planning
Collaboration & Communication
Documentation & Compliance
Quality & Professional Development
Knowledge, Skills & Abilities
Minimum Qualifications
Education
Experience
License and Certification
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions:
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
About Duke University Hospital
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
Duke Nursing Highlights:
- Duke University Health System is designated as a Magnet organization
- Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
- Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
- Duke University Health System has 6000 + registered nurses
- Quality of Life: Living in the Triangle!
- Relocation Assistance (based on eligibility)
Inpatient Case Management or Transplant experience and NC LCSW License Highly Preferred
The Case Manager is responsible for managing an assigned caseload to ensure timely assessment, planning, implementation, and evaluation of discharge plans and care transitions across the continuum of care. This role supports optimal patient outcomes, effective resource utilization, and compliance with CMS and other regulatory agencies. The Case Manager collaborates closely with interdisciplinary teams, patients, families, and community partners to coordinate safe, efficient care transitions.
Key Responsibilities
Care Coordination & Discharge Planning
- Assess all assigned patients for case management needs, including discharge planning, care transitions, advocacy, consultations, and patient/family education.
- Develop, implement, and evaluate individualized discharge plans ensuring timely and appropriate transitions of care.
- Coordinate services such as Home Health, Durable Medical Equipment (DME), transportation, Substance Abuse Treatment, outpatient follow-up, Skilled Nursing Facility (SNF) placement, and Acute Rehab referrals.
- Monitor daily census to ensure all patients are evaluated for case management needs.
Collaboration & Communication
- Maintain effective communication with the healthcare team regarding assessment findings, discharge needs, and provider orders.
- Provide education to patients, families, and care teams regarding benefits, reimbursement guidelines, and regulatory requirements.
- Collaborate with Utilization Management to support payer negotiations, reduce denials, and promote appropriate resource use.
Documentation & Compliance
- Maintain timely, accurate documentation of assessments, interventions, discharge arrangements, and all actions taken.
- Ensure compliance with federal, state, and local regulations, as well as organizational policies.
- Prepare reports and maintain records as required.
Quality & Professional Development
- Participate in Quality Assurance/Performance Improvement (QAPI) activities.
- Represent the department with professionalism while fostering positive working relationships across Duke Health and external partners.
- Provide weekend, holiday, or after-hours coverage as assigned based on entity needs.
Knowledge, Skills & Abilities
- Ability to work independently in a self-directed role.
- Strong problem-solving skills and ability to manage complex situations.
- Excellent written and verbal communication skills.
- Basic computer proficiency.
Minimum Qualifications
Education
- BSN or MSW required
Experience
- Minimum of 3 years of relevant experience
License and Certification
- Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire
- For BSN-prepared candidates: Must hold a current RN license (or compact license) in the state of North Carolina.
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions:
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
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