Credit Balancing Specialist - 241942

Now Hiring: Remote Credit Balance Specialist (Medicare Advantage Claims)


Looking for a fully remote opportunity with long-term potential in healthcare revenue cycle management? This role is perfect for someone with strong Medicare Advantage experience and a passion for resolving overpayments, investigating claim issues, and navigating complex payer systems. Join a mission-driven team that fosters growth, promotes from within, and values accountability, quality, and professional development.


Position Overview

As a Credit Balance Specialist, you'll be responsible for resolving Medicare Advantage insurance claims with existing credit balances. You'll work with multiple systems, payer portals, and accounting tools to ensure accurate and timely processing of refunds, adjustments, and retractions.


Key Responsibilities

  • Investigate and resolve Medicare Advantage credit balance claims
  • Initiate claim adjustments, retractions, or refunds
  • Research overpayments and apply root cause analysis
  • Navigate payer portals and call lines to resolve outstanding issues
  • Manage a high-volume queue of 30+ accounts per day with 95%+ quality
  • Collaborate cross-functionally and communicate professionally with stakeholders
  • Stay current with industry and regulatory changes


What You Need to Succeed

Must-Have Qualifications:

  • 3+ years in revenue cycle roles (billing, collections, A/R, or refunds)
  • Experience with Medicare Advantage claims (required)
  • Knowledge of credit balance workflows and payer reimbursement methodologies
  • Strong computer literacy (Excel, Outlook, Word)
  • Reliable work-from-home setup
  • High attention to detail and ability to work independently


Nice-to-Have:

  • Overpayment remediation or credit analysis experience
  • Familiarity with root cause resolution and regulatory compliance


Schedule & Start Time

  • Full-time (40 hrs/week) | Monday–Friday
  • Start time depends on your time zone:
  • PST: 5:00 AM – 8:00 AM
  • MST: 6:00 AM – 9:00 AM
  • CST: 7:00 AM – 8:00 AM
  • EST: 8:00 AM – 9:00 AM
  • Once selected, your start time must remain consistent


Why This Role Stands Out

  • 100% Remote – work from anywhere in the U.S. (except CA)
  • Career Growth – potential to convert to a full-time employee with promotion paths to Revenue Specialist II, III, Team Lead, and more
  • Positive Culture – collaborative, people-first environment that supports personal and professional development


Ready to Apply?

We’re seeking dependable, experienced revenue cycle professionals who are ready to hit the ground running. If you’re passionate about healthcare, organized, and eager to work with a respected, national healthcare brand — this could be your next big opportunity.

Apply now to get started!