Senior Billing Operations Specialist - Denials & Payments

Justremote; United States; A distancia; USD 68.000 - 103.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision insurance

FSA/HSA

Equity via RSUs

Paid vacation, sick days & holidays

Paid parental leave

401K with matching

Monthly tech allowance

Well-being perks

Community celebrations

Descripción de la vacante

Lyra Health is seeking a senior healthcare billing specialist to serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation. You will expertly analyze EOBs and ERAs to identify root causes and take ownership of complex denied claims.

You will manage high-volume payments from health plans, resolve discrepancies, and mentor junior team members while adhering to SOPs and compliance guidelines.

Formación

• Minimum 5 years in healthcare billing with progression.
• Expertise reading EOBs and ERAs.
• Understanding of full claim lifecycle.
• Proficient with payer portals and billing software.
• High accuracy data entry.
• Strong attention to detail and problem solving.
• Excellent organizational and time-management skills.
• Strong written and verbal communication.
• Ability to mentor junior team members.

Responsabilidades

• Serve as SME in claim denials, payment posting, and remittance reconciliation.
• Analyze EOBs and ERAs to identify root causes of denials or discrepancies.
• Take ownership of complex denied claims and resubmit accurately.
• Manage posting of high-volume payments from health plans to patient accounts.
• Identify and resolve discrepancies between expected and actual payments.
• Lead follow-up on outstanding denials and underpayments via payer portals, calls, and letters.
• Prepare documentation for complex appeals.
• Maintain organized records in the billing system.
• Collaborate with team to optimize queue management and mentor juniors.
• Adhere to SOPs and compliance guidelines.
• Identify trends in denials and payment discrepancies and suggest process improvements.
• Provide mentorship and support to junior team members.

Conocimientos

EOB/ERA analysis

Denial resolution

Payer portal navigation

Healthcare billing lifecycle

Data entry accuracy

Attention to detail

Time management

Communication skills

Mentoring juniors

Herramientas

Billing software

Descripción del empleo

Lyra Health is seeking a senior healthcare billing specialist to serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation. You will expertly analyze EOBs and ERAs to identify root causes and take ownership of complex denied claims.

You will manage high-volume payments from health plans, resolve discrepancies, and mentor junior team members while adhering to SOPs and compliance guidelines.