Refund and Credit Balance Coordinator

About North Country Healthcare (NCH):

North Country Healthcare is a non-profit affiliation of four medical facilities, Androscoggin Valley Hospital, North Country Home Health & Hospice Agency, Upper Connecticut Valley Hospital, and Weeks Medical Center, located in the White Mountains Region of New Hampshire. NCH includes numerous physicians and medical providers at multiple locations. This leading comprehensive healthcare network which employs hundreds of highly-trained individuals delivers integrated patient care through three community hospitals, specialty clinics, and home health and hospice services. NCH remains committed to the health and well-being of the communities we serve. As a leader in a management position this role emphasizes advancing High-Reliability Organization (HRO) principles, embedding a culture of safety, accountability, and consistent high performance.

POSITION SUMMARY:

The Refund/Credit Balance Coordinator is responsible for the timely and accurate review, reconciliation, and processing of patient and insurance credit balances within the revenue cycle. This role ensures compliance with federal, state, and payer-specific refund regulations while supporting internal audit processes and promoting financial accuracy across the organization. The coordinator will work closely with NCH’s contracted credit balance vendor to ensure resolution of outstanding credits in a timely and compliant manner.

ESSENTIAL QUALIFICATIONS

Education:

• High school diploma or equivalent required; Associate’s degree preferred.

Certification:

• N/A

Licensure:

• Association* accredited course in Basic Life Support (BLS) (for clinical staff), or Heartsaver CPR AED (for nonclinical staff), and renewal on a regular basis, with up to a three-month grace period after the expiration date.

Skills:

• Strong analytical and problem-solving skills with a keen attention to detail.
• Proficiency in electronic health record systems and Microsoft Excel.
• Demonstrated ability to interpret explanation of benefits (EOBs), payer guidelines, and contractual adjustments.
• Excellent organizational and time-management skills to handle multiple priorities.
• Strong interpersonal skills and ability to work collaboratively within a team environment.

Work Experience:

• Minimum of 2 years of experience in medical billing, revenue cycle, healthcare finance, or administrative support.
• Experience working with third-party vendors or external partners in a healthcare finance setting preferred.

ESSENTIAL FUNCTIONS: 

1. Analyze and resolve credit balances by investigating overpayments from insurance carriers and patients.
2. Initiate and process refund requests in accordance with NCH policy and regulatory guidelines.
3. Collaborate with billing, cash posting, and payer representatives to prevent and correct erroneous payments.
4. Serve as the primary internal contact for coordination with the credit balance vendor, supporting data exchange, account validation, and issue resolution.
5. Monitor vendor activity and assist in prioritizing accounts for timely resolution.
6. Document account activities accurately and consistently in the patient accounting system.
7. Respond to patient and payer inquiries regarding overpayments and refunds.
8. Maintain accurate records of all refunds issued and assist with monthly reporting requirements.
9. Participate in internal audits and support the integrity of the refund workflow.
10. Identify patterns or trends in overpayments and recommend process improvements.
11. Ensure all activities adhere to HIPAA, Medicare, Medicaid, and third-party payer regulations.
12. Work collaboratively with colleagues across Patient Financial Services and other departments to maintain a high standard of service and financial stewardship.

NON-ESSENTIAL FUNCTIONS

1. Performs additional duties as assigned.
2. Adheres to facility Values, Service Excellence and Standards of Excellence.