Insurance Credit Specialist

The Insurance Credit Specialist supports Lifepoint Health’s Medical Group Revenue Integrity team by reviewing and resolving insurance and patient credit balances. This role focuses on analyzing account balances, researching explanation of benefits, following up with insurance carriers, processing refund requests, and correcting errors related to insurance contractual adjustments.

The specialist works with insurance companies, patient account information, EOBs, credit balance reports, unapplied cash activity, and revenue cycle systems to ensure refunds and account corrections are completed accurately and within required timelines. This role requires knowledge of payer reimbursement, insurance billing, follow-up workflows, and protected health information confidentiality.

### Key Responsibilities

* Review insurance and patient credit balance reports
* Resolve patient and insurance credit balance refunds
* Research unapplied cash activity
* Analyze explanations of benefits from insurance carriers
* Contact insurance companies for additional information
* Follow up with payers by phone, email, and insurance websites
* Document requests and concerns on patient accounts
* Respond to refund requests within required timelines
* Identify root causes of refund activity
* Report recurring refund issues to management
* Correct contractual adjustment posting errors
* Maintain confidentiality of protected health information
* Follow revenue cycle policies and procedures
* Support accurate insurance credit resolution

### Requirements

* High School Diploma or GED
* 1+ year insurance billing or insurance follow-up experience
* Medicare, Medicaid, and commercial payer experience
* Experience reviewing EOBs
* Understanding of insurance payment processes
* Ability to research account balances
* Ability to communicate with insurance carriers
* Strong documentation skills
* Strong attention to detail
* Ability to manage daily volume expectations
* Knowledge of PHI confidentiality requirements

### Preferred Qualifications

* Associate Degree
* Bachelor’s Degree in Healthcare Administration or related field
* Medical terminology knowledge
* CPT coding knowledge
* ICD-10 coding knowledge
* Credit balance experience
* Refund processing experience
* Unapplied cash research experience
* Revenue cycle experience

### Benefits

* Medical insurance
* Dental insurance
* Vision insurance
* Paid time off
* Paid family leave
* Life insurance
* Accident insurance
* Critical illness insurance
* Hospital indemnity insurance
* Short-term disability insurance
* Long-term disability insurance
* Tuition assistance
* Certification tuition assistance
* Loan assistance
* 401(k) with company match
* Wellness programs
* Virtual care appointments
* Mental health services
* Discount programs
* Career advancement opportunities
* Bonus eligibility

### Phone Level Breakdown

* Insurance carrier follow-up: Moderate
* Email communication: Moderate
* Insurance website research: High
* EOB review: High
* Refund processing: High
* Patient interaction: Low

### Best Fit For

Candidates with experience in insurance billing, insurance follow-up, accounts receivable, credit balance resolution, refund processing, EOB review, unapplied cash research, medical billing, revenue cycle management, payer research, and healthcare reimbursement.