Sr. Billing Operations Associate

• 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.