Team Lead Refunds - US Medical Claim

At Strivant Health, accurate and timely refund processing is essential to maintaining compliant account balances and delivering a positive experience for patients and clients. As a Refunds Team Lead you will provide leadership, coaching, training, and operational support for team members responsible for researching credit balances and processing patient and third-party payer refunds.

This role combines team leadership, quality oversight, workflow management, and hands-on production support. You will oversee refund submissions, documentation, approvals, follow-up activities, and completed refund reconciliation. You will also help team members resolve complex refund issues, identify error trends, strengthen internal controls, and implement process improvements.

The ideal candidate is analytical, highly detail-oriented, and passionate about developing team members while maintaining accuracy, compliance, and timely refund resolution.

What You’ll Do - Your Impact Matters

• Lead, coach, mentor, and develop Refunds team members to achieve productivity, quality, accuracy, and service goals.
• Serve as a primary resource for complex credit balance research, refund workflow questions, escalations, and account discrepancies.
• Oversee the research, auditing, and processing of refunds for patients and third-party payers.
• Monitor daily workloads, outstanding refunds, follow-up activities, refund trackers, and approval statuses.
• Conduct quality reviews of refund packets to ensure complete and accurate supporting documentation.
• Identify missing or inaccurate information and communicate required corrections to clinics, clients, and internal teams.
• Monitor credit balances and determine whether accounts are eligible for refunds or require another resolution.
• Ensure approved credits are properly cleared from applicable systems and completed refunds are reconciled.
• Help prevent duplicate refund requests through effective auditing, tracking, and review controls.
• Collaborate with offshore team members to review daily refund submissions and provide coaching when concerns are identified.
• Support client signature and approval processes and track refund packets through completion.
• Oversee monthly credit reporting and follow-up with clinics or internal teams on outstanding items.
• Monitor patient refund status communications through approved email or SMS methods.
• Assist with workload distribution, backlog resolution, and hands-on production support during peak volumes or staffing shortages.
• Analyze refund errors and quality trends, identify root causes, and implement corrective actions and process improvements.
• Support onboarding, employee training, cross-training, SOP development, and ongoing team development.
• Generate reports and monitor performance metrics related to refunds, credit balances, outstanding items, quality, and productivity.
• Collaborate with clients, accounting, and cross-functional revenue cycle teams to resolve discrepancies and improve refund workflows.
• Ensure refund activities comply with HIPAA and other applicable regulatory and organizational requirements.
• Support special projects and other operational responsibilities assigned by management.

What You Bring to the Table

• High school diploma or equivalent required. Bachelor’s degree in healthcare, finance, accounting, business, or a related field preferred.
• Minimum 3 years of experience in medical billing refunds, credit balance resolution, payment posting, or medical accounts receivable operations.
• At least 1 year of leadership, mentoring, team lead, supervisory, or demonstrated internal mentorship experience preferred.
• Strong understanding of patient and insurance refunds, credit balances, medical terminology, reimbursement processes, and payer requirements.
• Experience reviewing refund packets, identifying documentation errors, reconciling completed refunds, and preventing duplicate requests.
• Experience performing quality reviews, identifying error trends, and implementing corrective actions or process improvements.
• Ability to analyze ledgers, credits, account activity, and supporting documentation to resolve discrepancies.
• Strong attention to detail, analytical thinking, organizational skills, and problem-solving ability.
• Excellent written and verbal English communication skills.
• Intermediate proficiency with Microsoft Office applications, including Excel, Outlook, and Word.
• Ability to manage competing priorities, meet deadlines, and work effectively in a fast-paced environment.
• Ability to communicate directly, professionally, and empathetically with team members, clients, clinics, patients, and internal departments.
• Passion for developing team members and driving operational excellence.