Lead Payments and Refund Specialist

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Supervise the daily activities related to payment posting and refund processing across all departments.

• Act as the subject matter expert in payment reconciliation, management of patient credit balances, and the handling of refunds.

• Offer guidance, training, onboarding, and support to the Payments and Refund Specialists.

• Be the primary resource and mentor for the Payments and Refunds team.

• Oversee work queues and productivity levels to guarantee timely posting and processing of refunds.

• Evaluate team performance and provide constructive feedback aimed at enhancing quality and efficiency.

• Assist in the development and upkeep of departmental policies and procedures.

• Escalate complex issues regarding payments, reconciliation, or refunds to the RCM Director.

• Facilitate cross-functional collaboration with Billing, Follow-Up, Credentialing, and Front Office teams.

• Ensure precision, compliance, process enhancements, and the attainment of departmental objectives.

⛳️ Requirements

• A high school diploma or equivalent is necessary.

• A minimum of 5 years of experience in medical billing, payment posting, or revenue cycle operations is required.

• Strong understanding of medical insurance plans, including Medicare, Medicaid, Tricare, and commercial payers.

• In-depth knowledge of ERA/EOB processing, payment reconciliation, and refund management.

• Familiarity with CPT, ICD-10, and regulations governing medical billing.

• Experience with practice management systems, EHR platforms, and clearinghouses.

• Advanced skills in Microsoft Excel, with a focus on reporting and data analysis.

• A minimum of 1-2 years of experience in a lead, supervisory, or mentoring role is preferred.

• Strong analytical, organizational, and problem-solving abilities.

• Exceptional written and verbal communication skills.

• Capability to manage multiple priorities while ensuring a high level of accuracy.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment focused on teamwork and collaboration.