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Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.
$18/hr–$26/hr
Other
high school, associate degree
Posted 8d ago
~40 hrs/week
Remote in Greenville, North Carolina, United States
Responsibilities
The Team Lead oversees credit balance resolution staff, providing training and monitoring daily workflows to ensure accurate reconciliation of accounts. They are responsible for resolving complex credit balances, undistributed payments, and refund requests while maintaining compliance with regulatory and contractual requirements.
Requirements
Candidates must have at least five years of experience in finance, insurance, or healthcare revenue cycle roles, with leadership experience preferred. A high school diploma is the minimum education required, though an associate degree in a relevant field is also accepted.
Full job description
Position Summary
The position serves as a technical expert lead for other Credit Balance Resolution staff and is responsible for training new staff, providing ongoing training to existing staff, as well as performing all of the duties of the Credit Balance Resolution Specialist. A significant degree of independent judgment and decision making is required. Responsible for ensuring the Medicare quarterly credit balance report is completed in a timely manner along with all other governmental credit balance audits requests and unclaimed property. It provides some leadership and direction of the credit balance staff in daily credit balance workflow functions. Assist in creating, implementing and updating the policies and procedures for Credit Balance Resolution as well as following the departmental policies and procedures.
Responsible for resolving credit balances, undistributed payments, and requests for refunds due to insurance companies, patients, or other payers through extensive phone, fax, and written correspondence. This position is responsible for working with internal and external customers (e.g., third party payers, patients/guarantors, estate representatives, attorneys, employers, and ECU Health employees) to facilitate the prompt resolution of credit balances or requests for refunds.
This involves researching insurance benefits, understanding coordination of benefits between payers, distributing/reapplying or transferring payments to the appropriate date of service/provider or account, and then updating account adjustments, generating refund requests, overpayment notifications or denying refund request according to guidelines. Accurate and timely resolution of overpays, undistributed payments and requests for refunds is based on a knowledge and understanding of contractual obligations as well as regulatory requirements.
Responsibilities
Provide general assistance to the Credit Balance team.
Train new staff and provide ongoing training for existing staff.
Monitor activities performed by Credit Balance staff to make sure that accounts (credit balance, undistributed payments, and requests for refunds) are reconciled appropriately and timely.
Complete quality improvement and productivity activities.
Answer questions regarding team functions and assist with team direction.
Reviews credit balances, undistributed payments and requests for refunds to determine the appropriate course of action needed.
Conducts timely and accurate review of credit balances, undistributed payments and requests for refunds to determine the appropriate course of action needed.
Initiate refunds to patients/guarantors, insurance companies, and other third parties by following established refund. procedures, contractual obligations, payer and regulatory requirements.
Conduct timely and accurate review of refund requests from payers with contracted recoupment language to reduce. future recoupment reconciliations.
Responsible for reviewing, validating and correcting adjustments on accounts based on insurance reimbursement, benefit coverage guidelines, contracted payers, and services provided.
Redistribute and/or transfer payments between PB/HB accounts.
Validate and update patient demographic and insurance information to ensure accuracy of future claims.
Reconcile misdirected and clearing accounts by researching and posting payments to the correct accounts.
Ensures correct reimbursement rates are reflected in refund requests.
Maintains appropriate and accurate system documentation with notes and standard note codes.
Adhere to Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies.
Review and resolve accounts assigned via work lists daily as directed by management.
Supporting the Manager as needed.
Minimum Requirements
Required Education/Course(s)/Training:
High school diploma or equivalent or higher.
Associate Degree in Business, Finance, Health Information Management and/or three years of experience in a healthcare revenue cycle or clinic operations leadership role with progressive responsibilities.
Minimum of five years of experience in insurance, finance, medical office, or customer service-related field.
Knowledge of managed care contract billing guidelines is required.
Revenue Cycle (healthcare business, financial, or insurance) experience.
Epic experience.
Knowledge of medical and insurance terminology, CPT, ICD & HCPCS coding structures, and billing forms (UB, 1500).
Required Skills, Knowledge, and Abilities:
Effective interpersonal skills, including the ability to promote teamwork. Must have excellent time management skills and be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner.
Basic math skills and knowledge of general accounting principles.
Ability to ensure a high level of customer satisfaction.
Must be able to work well with others.
Strong verbal and written communication skills required.
Must be detail oriented and organized.
High integrity, including maintenance of confidential information.
Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency.
Illustrates autonomous, best revenue cycle practices.
Illustrates proficiency in the use of all internal automation and software applications.
Skill Set Requirement:
Strong problem-solving skills.
Strong quantitative, analytical and organizational skills.
Advanced understanding of an Explanation of Benefits (EOB).
Knowledge of CPT, ICD-10, and HCPCS coding standards.
Understand CMS Memos and Transmittals.
Utilize and understand computer technology.
Communicate orally and in written form.
Ability to manage multiple tasks with ease and efficiency.
Self-starter with a willingness to try new ideas.
Ability to work independently and be result oriented.
Understand insurance terms and payment methodologies.
Pay Range
$18.38 - $26.79/hr
Other Information
Onsite role (based out of Greenville, NC)
Monday - Friday day shift
Great Benefits
#LI-REMOTE
#LI-AH2
ECU Health
About ECU Health
ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.
The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children¿s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.
General Statement
It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant¿s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.
Related keywords
Credit BalanceRevenue CycleMedicareInsuranceRefundsEpicCPTICD-10HCPCSBillingComplianceAuditsHealthcareFinanceAccountingManaged Care
Improving the health and well-being of eastern North Carolina
Industry
Hospitals and Health Care
Company size
10,001+ employees
Headquarters
Greenville, North Carolina
LinkedIn followers
23,872
We come to work every day in order to help you and the 1.4 million people like you across eastern North Carolina. In the face of a rapidly changing health care landscape — increasing competition, advancing technologies and a host of other external pressures — many health care systems lose sight of what’s important. Not ECU Health. Even as we grow, we know that progress isn’t just about moving forward. It’s about how we move forward. That’s why we’ve always been, and always will be, a mission-driven health care system. Our mission, vision and values continue to lead us on a voyage to excellence. Because the people we take care of — our neighbors, friends and family — deserve the best.
Offices: 2100 Stantonsburg Rd, Greenville, North Carolina 27834, US
How much do Healthcare jobs in North Carolina pay?
Based on 2252 listings with disclosed salaries, most healthcare jobs in North Carolina pay between $59k–$162k per year. Individual offers vary with seniority, company size, and specialization.
How many Healthcare jobs are open in North Carolina right now?
There are currently 17,557 open healthcare positions in North Carolina listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in North Carolina?
Companies currently hiring include American Addiction Centers, Duke Health Technology Solutions, CVS Health, Duke University Hospital, PruittHealth, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in North Carolina?
Yes — 1796 of the 17557 open healthcare positions offer remote or hybrid work (660 remote, 1136 hybrid).
How do I apply for Healthcare jobs in North Carolina?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.