Sr. Billing Operations Associate

Justremote; United States; Remote; USD 68,000 - 103,000; Full time

Benefits offered by this job

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

Job summary

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.

Qualifications

• 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.

Responsibilities

• 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.

Skills

EOB/ERA analysis

Denial resolution

Payer portal navigation

Healthcare billing lifecycle

Data entry accuracy

Attention to detail

Time management

Communication skills

Mentoring juniors

Tools

Billing software

Job description

About:

• Serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation.
• Expertly analyze Explanation of Benefits (EOBs) and remittance advice (RAs) to identify intricate root causes of denials or payment discrepancies.
• Proactively take ownership of complex denied claims, conducting in-depth investigations and ensuring accurate resubmission of claims.
• Independently manage the accurate posting of high-volume and complex payments from health plans to patient accounts.
• Identify, analyze, and independently resolve discrepancies between expected and actual payments.
• Lead proactive follow-up on outstanding denials and underpayments using payer portals, phone communication, and written correspondence.
• Prepare comprehensive documentation for complex appeals based on nuanced denial reasons.
• Maintain meticulously organized records in the billing system.
• Collaborate with team members to optimize queue management and support junior team members.
• Adhere to established Standard Operating Procedures (SOPs) and compliance guidelines.
• Identify complex denial or reconciliation issues and develop solutions.
• Lead the identification of trends in denials and payment discrepancies, proposing process improvements.
• Provide mentorship, guidance, and support to junior team members.

Experience:

• A minimum of 5 years of progressively responsible experience in healthcare billing.
• Proven expertise in reading and interpreting Explanation of Benefits (EOBs) and electronic remittance advice (ERAs).
• In-depth understanding of the complete claim lifecycle.
• Experience navigating complex payer portals and using billing software with advanced proficiency.
• Exceptional data entry skills with a track record of accuracy.
• Strong attention to detail and problem-solving skills.
• Outstanding organizational and time management skills.
• Professional written and verbal communication skills.
• Commitment to adhering to established procedures and guidelines.
• Proactive, solution-oriented approach to resolving billing issues.
• Experience in mentoring and supporting junior team members.

Salary and Perks:

Pay range: $68K - $103K

• Comprehensive healthcare coverage including medical, dental, vision, FSA/HSA, life and disability insurances.
• 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.
• Well-being perks and activities.
• Surprise swag and regular community celebration.

About Lyra Health:

Our mission is to transform access to life-changing mental health care.