Alliance Health in
Encounter Team Lead (Full Time, Remote, North Carolina Based)
Alliance Health in, Morrisville, North Carolina, United States, 27560
Encounter Team Lead (Full Time, Remote, North Carolina Based)
Job Category:
Claims
Requisition Number:
ENCOU003190
Posted : September 25, 2025 Full-Time Hybrid
Locations Showing 1 location
Home Office Morrisville, NC 27560, USA
Description The Encounter Team Lead provides training/development, consultation, and direction to Encounter Analysts and collaborates with Encounter Manager and other departments to improve Encounter processes and Claims system changes. The Encounter Team Lead also facilitates peer reviews and independent AR audits to identify areas for improvement and correction. The position provides guidance and training/technical assistance to delegated vendors to strengthen the performance of Alliance Health Encounter Service Level Agreements. This position creates reporting tools to aid in identification of areas needing attention and to communicate performance.
This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, the selected candidate will be required to come into the Alliance Office for business and team meetings as needed.
Responsibilities & Duties
Provide Guidance and Consultation to Encounter Analysts
Assist the Encounter Analysts in reviewing claim errors
Provide daily consultation to Encounter Analysts to resolve processing issues
Facilitate monthly peer reviews
Ensure staff is taking the appropriate steps even when it may require escalation for resolution
Role model professional communication and conduct at all times
Provide Training and Development to Encounter Analysts
Provide claims/encounters processing training for new and existing staff
Onboard and train new staff members
Provide ongoing in-person and virtual learning opportunities to include 1:1 training, shadowing, provision of routine feedback
Assist in creation of desk procedures
Analyze Data and Make Recommendations
Review and analyze daily, weekly and monthly reports to help track progress and recommend procedure and process changes to increase productivity
Review Encounter production and quality levels for performance and monitor Provider feedback. Communicate areas of staff performance concerns to Encounter Manager
Monitor and record performance measures and compile associated reports
Improve Quality of Encounter Processing Procedures and Performance
Develop and implement approved and updated procedures and desk references to improve quality and performance
Stay abreast of related regulatory, compliance and departmental updates to meet departmental metric requirements
Collaborate with IT, Enrollment, Provider Network, and Claim teams to assist with successful encounter submissions
Maintain a working knowledge of cross departmental functions to appropriately advise on encounter-related issues
Provide backup coverage to supervisory staff as needed
Support Expansion and New Business
Learn new skills related to expansion and new business requirements per Alliance Health & Vendor contracts. This includes, but is not limited to: coverage of additional catchment areas, new covered services, processing and handling of physical health claims
Education & Experience
High school diploma or equivalent and five (5) or more years of experience processing behavioral or physical health claims and analyzing claims processing data
Preferred :
Experience with Medicaid and State claims processing and/or claims denial management
Experience with Medicaid and State Encounter data
Experience leading a team and conducting trainings and presentations
Knowledge, Skills, & Abilities
Training/Presentation
Organization
Knowledge of Electronic Data Interchange (EDI) files
Knowledge of Medicaid Claims processing
Working knowledge of AR system
Customer Service; Interpersonal Relationships
Good written and oral communication skills
Research, statistical analysis and reporting skills
Complex Problem Solving
Ability to communicate technical concepts to lay persons
Ability to make prompt decisions on complex matters and make evaluations concerning day to day operations
Ability to prepare concise and accurate reports and plans
Salary Range
$25.75 - $34.12/ Hourly
Exact compensation will be determined based on the candidate\'s education, experience, external market data and consideration of internal equity
An excellent fringe benefit package accompanies the salary, which includes:
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility
Qualifications Education Required High School or better in General Studies.
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.
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Claims
Requisition Number:
ENCOU003190
Posted : September 25, 2025 Full-Time Hybrid
Locations Showing 1 location
Home Office Morrisville, NC 27560, USA
Description The Encounter Team Lead provides training/development, consultation, and direction to Encounter Analysts and collaborates with Encounter Manager and other departments to improve Encounter processes and Claims system changes. The Encounter Team Lead also facilitates peer reviews and independent AR audits to identify areas for improvement and correction. The position provides guidance and training/technical assistance to delegated vendors to strengthen the performance of Alliance Health Encounter Service Level Agreements. This position creates reporting tools to aid in identification of areas needing attention and to communicate performance.
This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, the selected candidate will be required to come into the Alliance Office for business and team meetings as needed.
Responsibilities & Duties
Provide Guidance and Consultation to Encounter Analysts
Assist the Encounter Analysts in reviewing claim errors
Provide daily consultation to Encounter Analysts to resolve processing issues
Facilitate monthly peer reviews
Ensure staff is taking the appropriate steps even when it may require escalation for resolution
Role model professional communication and conduct at all times
Provide Training and Development to Encounter Analysts
Provide claims/encounters processing training for new and existing staff
Onboard and train new staff members
Provide ongoing in-person and virtual learning opportunities to include 1:1 training, shadowing, provision of routine feedback
Assist in creation of desk procedures
Analyze Data and Make Recommendations
Review and analyze daily, weekly and monthly reports to help track progress and recommend procedure and process changes to increase productivity
Review Encounter production and quality levels for performance and monitor Provider feedback. Communicate areas of staff performance concerns to Encounter Manager
Monitor and record performance measures and compile associated reports
Improve Quality of Encounter Processing Procedures and Performance
Develop and implement approved and updated procedures and desk references to improve quality and performance
Stay abreast of related regulatory, compliance and departmental updates to meet departmental metric requirements
Collaborate with IT, Enrollment, Provider Network, and Claim teams to assist with successful encounter submissions
Maintain a working knowledge of cross departmental functions to appropriately advise on encounter-related issues
Provide backup coverage to supervisory staff as needed
Support Expansion and New Business
Learn new skills related to expansion and new business requirements per Alliance Health & Vendor contracts. This includes, but is not limited to: coverage of additional catchment areas, new covered services, processing and handling of physical health claims
Education & Experience
High school diploma or equivalent and five (5) or more years of experience processing behavioral or physical health claims and analyzing claims processing data
Preferred :
Experience with Medicaid and State claims processing and/or claims denial management
Experience with Medicaid and State Encounter data
Experience leading a team and conducting trainings and presentations
Knowledge, Skills, & Abilities
Training/Presentation
Organization
Knowledge of Electronic Data Interchange (EDI) files
Knowledge of Medicaid Claims processing
Working knowledge of AR system
Customer Service; Interpersonal Relationships
Good written and oral communication skills
Research, statistical analysis and reporting skills
Complex Problem Solving
Ability to communicate technical concepts to lay persons
Ability to make prompt decisions on complex matters and make evaluations concerning day to day operations
Ability to prepare concise and accurate reports and plans
Salary Range
$25.75 - $34.12/ Hourly
Exact compensation will be determined based on the candidate\'s education, experience, external market data and consideration of internal equity
An excellent fringe benefit package accompanies the salary, which includes:
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility
Qualifications Education Required High School or better in General Studies.
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr