Senior Healthcare Billing & Denials Specialist

Lyra Health, Inc.; Oregon; Hybride; USD 68 000 - 104 000; Plein temps

Avantages offerts par ce poste

Healthcare coverage

Coaching and therapy services

Equity RSUs

Paid time off

Parental leave

401K matching

Tech allowance

Well-being perks

Résumé du poste

Lyra Health, Inc. is seeking a detail-oriented Sr. Billing Operations Associate in Oregon to support health plan billing workflows. You will lead denial resolution, posting, and remittance reconciliation, ensuring accurate and timely processing of claims and payments from health plan partners.

You will analyze EOBs and ERAs, investigate denials, and resubmit claims while maintaining meticulous records and adherence to SOPs. Collaboration with the team and senior staff is essential.

Qualifications

• 5+ years of healthcare billing experience and independently handling complex denials, posting, and reconciling remittances.
• Ability to read EOBs and ERAs to resolve a wide range of billing issues.
• Deep understanding of the complete claim lifecycle, denial reasons, and payer rules.
• Proficient navigation of payer portals and billing software for high-volume posting and follow-up.
• Impeccable data entry accuracy in posting payments and updating claim information.
• Strong written and verbal communication with payers and internal teams.

Responsabilités

• Serve as SME in claim denials, posting, and remittance reconciliation, managing complex queues.
• Analyze EOBs and ERAs to identify root causes and develop resolution strategies.
• Lead ownership of complex denied claims, investigate and resubmit accurately to payers.
• Post high-volume and complex payments to patient accounts with precise allocation.
• Identify discrepancies between expected and actual payments and escalate where needed.
• Follow up on denials and underpayments via payer portals and written correspondence.
• Prepare documentation for complex appeals based on denial reasons and payer rules.
• Maintain well-organized billing records ensuring data integrity and audit readiness.
• Collaborate with teammates to optimize queue management and resolve issues.

Connaissances

Claim denials

Payment posting

Remittance reconciliation

EOB interpretation

Payer portals

Data entry

Analytical thinking

Documentation

Communication skills

Mentoring others

Outils

Billing software

ERP systems

Remittance software

Description du poste

Lyra Health, Inc. is seeking a detail-oriented Sr. Billing Operations Associate in Oregon to support health plan billing workflows. You will lead denial resolution, posting, and remittance reconciliation, ensuring accurate and timely processing of claims and payments from health plan partners.

You will analyze EOBs and ERAs, investigate denials, and resubmit claims while maintaining meticulous records and adherence to SOPs. Collaboration with the team and senior staff is essential.