Senior Billing Ops Lead - Healthcare A/R & Denials

Remote; San Francisco (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Lyra Health is seeking a detail-focused Billing Associate to bolster our Health Plan Billing Operations, handling complex denials and payments from partner health plans. You will expertly analyze EOBs and remittance advice to uncover root causes and ensure timely, accurate resubmissions.

You will independently post high-volume payments, reconcile with bank deposits, and escalate only novel, impactful issues.

Qualifications

• Minimum 5 years of healthcare billing experience, including denial management and remittance posting.
• Deep understanding of Explanation of Benefits (EOBs) and electronic remittance advice (ERAs).
• Knowledge of payer rules, denial reasons, and appeals processes.
• Experience navigating payer portals and billing software for high-volume posting and follow-up.
• Strong data accuracy and ability to maintain audit-ready records.

Responsibilities

• Serve as SME in claim denials, payment posting, and remittance reconciliation.
• Analyze EOBs and remittance advice to identify root causes of denials and discrepancies.
• Own complex denied claims, investigate and correct errors, resubmit to payers.
• Post high-volume payments accurately and reconcile with bank deposits.
• Identify and resolve discrepancies between expected and actual payments; escalate only high-impact issues.
• Lead follow-up on outstanding denials and underpayments via payer portals and clear communications.
• Prepare documentation for complex appeals, understanding payer-specific processes.
• Maintain meticulous records of billing actions for data integrity and audits.
• Collaborate with team to optimize queue management and resolve issues efficiently.
• Adhere to SOPs and regulatory guidelines; suggest process improvements.

Skills

Healthcare billing

Denials handling

Remittance posting

EOB interpretation

Payer portals

Data entry

Analytical skills

Attention to detail

Time management

Mentoring

Tools

Billing software

Job description

Lyra Health is seeking a detail-focused Billing Associate to bolster our Health Plan Billing Operations, handling complex denials and payments from partner health plans. You will expertly analyze EOBs and remittance advice to uncover root causes and ensure timely, accurate resubmissions.

You will independently post high-volume payments, reconcile with bank deposits, and escalate only novel, impactful issues.