Sr. Billing Operations Associate

Lyra Health; Oregon; Hybrid; USD 68,000 - 104,000; Full time

Benefits offered by this job

Healthcare coverage

Coaching and therapy services

Equity RSUs

Paid time off

Parental leave

401K matching

Tech allowance

Well-being perks

Job summary

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.

Responsibilities

• 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.

Skills

Claim denials

Payment posting

Remittance reconciliation

EOB interpretation

Payer portals

Data entry

Analytical thinking

Documentation

Communication skills

Mentoring others

Tools

Billing software

ERP systems

Remittance software

Job description

About Lyra Health

Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra's transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions.

About the Role

Lyra is seeking a detail-oriented Billing Associate to support our Health Plan Billing Operations Teams accounts receivable (A/R) function. In this role, you'll be responsible for performing key billing functions to ensure accurate and timely processing of claim denials and payments from our health plan partners. This is an excellent opportunity to contribute to a growing team and develop your skills in a dynamic healthcare environment.

What You'll Do:

• Serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation, independently managing complex queues and demonstrating advanced understanding of workflow optimization.
• Expertly analyze Explanation of Benefits (EOBs) and remittance advice (RAs) to identify intricate root causes of denials or payment discrepancies, developing effective resolution strategies.
• Proactively take ownership of complex denied claims, conducting in-depth investigations, independently correcting intricate errors, and ensuring accurate and timely resubmission of claims to payers.
• Independently manage the accurate and efficient posting of high-volume and complex payments from health plans to patient accounts, ensuring precise allocation, thorough reconciliation with bank deposits, and proactive identification of systemic posting errors.
• Expertly identify, analyze, and independently resolve complex discrepancies between expected and actual payments, escalating only the most novel and high-impact issues.
• Lead proactive follow-up on outstanding denials and underpayments through expert utilization of payer portals, sophisticated phone communication, and clear, persuasive written correspondence.
• Independently prepare comprehensive and well-supported documentation for complex appeals based on nuanced denial reasons, demonstrating a thorough understanding of payer-specific appeal processes and regulations.
• Maintain meticulous and expertly organized records of all actions taken within the billing system, ensuring the highest level of data integrity and audit readiness.
• Collaborate strategically with team members to optimize efficient queue management, proactively contribute to the timely resolution of complex billing issues, and serve as a point of escalation and support for junior team members.
• Consistently adhere to and champion established Standard Operating Procedures (SOPs) and compliance guidelines, demonstrating a deep understanding of regulatory requirements and best practices.
• Proactively identify complex denial or reconciliation issues and independently develop potential solutions, presenting well-reasoned recommendations to senior team members.
• Lead the identification of trends in denials and payment discrepancies, proactively proposing and implementing significant process improvements within your area of expertise.
• Provide mentorship, guidance, and support to junior team members, fostering their professional development and contributing to the overall knowledge and skill level of the team.

What You'll Bring:

• A minimum of 5 years of progressively responsible experience in healthcare billing, with demonstrable expertise in independently managing complex claim denials, payment posting, and intricate remittance reconciliation.
• Proven subject matter expertise in reading and interpreting complex Explanation of Benefits (EOBs) and electronic remittance advice (ERAs) to resolve a wide range of challenging billing issues.
• Comprehensive and in-depth understanding of the complete claim lifecycle, including intricate and nuanced reasons for claim denials, advanced resolution strategies, and payer-specific rules and regulations.
• Extensive experience independently navigating a variety of complex payer portals and utilizing billing software with advanced proficiency for in-depth claim research, accurate high-volume payment posting, and strategic follow-up.
• Exceptional data entry skills with a consistent and verifiable track record of impeccable accuracy in posting high volumes of payments and updating complex claim information.
• Strong attention to detail and highly developed analytical and problem-solving skills to identify subtle and complex discrepancies in payments and intricate denial patterns.
• Outstanding organizational and time management skills, with a proven ability to independently manage complex workloads, strategically prioritize critical tasks, and consistently meet demanding deadlines.
• Highly professional and effective written and verbal communication skills, with the ability to clearly, concisely, and persuasively interact with payers and internal teams at all levels.
• A deep understanding of and commitment to consistently adhering to established procedures and guidelines, with the ability to identify and recommend improvements to existing processes.
• A highly proactive, solution-oriented, and leadership-driven approach to independently identifying, analyzing, and resolving complex billing issues, often anticipating challenges and leading with effective solutions.
• Demonstrated experience in mentoring and supporting junior team members, contributing to their growth and development.

$68,000 - $103,500 a year

As a full-time Sr. Billing Operations Associate, you will be employed by Lyra Health, Inc. The anticipated annual base salary range for this full-time position is $68,000 - 103,500. The base range is determined by role and level, and placement within the range will depend on a number of job-related factors, including but not limited to your skills, qualifications, experience and location. This role may also be eligible for discretionary bonuses.

Annual salary is only one part of an employee's total compensation package at Lyra. We also offer generous benefits that include:

• Comprehensive healthcare coverage (including medical, dental, vision, FSA/HSA, life and disability insurances)
• Lyra for Lyrians; coaching and therapy services
• Equity in the company through discretionary restricted stock units
• Competitive time off with pay policies including vacation, sick days, and company holidays
• Paid parental leave
• 401K with up to 3% matching
• Monthly tech allowance
• We like to spread joy throughout the year with well-being perks and activities, surprise swag, regular community celebration… and more!

We are an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information or any other category protected by law.