Senior Billing Operations Associate
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Job Description
Sr. Billing Operations Associate managing denials, payment posting, and remittance reconciliation for Lyra Health’s evidence-based mental health care platform. Supporting accurate health-plan billing operations and process improvement.
Responsibilities:
- Serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation
- Manage complex billing queues and optimize workflows
- Analyze EOBs and RAs to identify denial and payment discrepancy root causes
- Investigate, correct, and resubmit denied claims to payers
- Post high-volume health-plan payments to patient accounts and reconcile them with bank deposits
- Identify and resolve discrepancies between expected and actual payments
- Follow up on denials and underpayments using payer portals, phone communication, and written correspondence
- Prepare documentation for complex appeals
- Maintain accurate billing-system records and audit readiness
- Collaborate on queue management and resolve complex billing issues
- Support and escalate issues for junior team members
- Adhere to SOPs, compliance guidelines, and regulatory requirements
- Recommend solutions and process improvements
- Identify denial and payment-discrepancy trends
- Mentor and support junior team members
Requirements:
- A minimum of 5 years of progressively responsible experience in healthcare billing
- Demonstrable expertise in independently managing complex claim denials, payment posting, and intricate remittance reconciliation
- Subject matter expertise in reading and interpreting complex Explanation of Benefits (EOBs) and electronic remittance advice (ERAs)
- Comprehensive understanding of the complete claim lifecycle, claim denials, resolution strategies, and payer-specific rules and regulations
- Experience navigating complex payer portals and using billing software for claim research, high-volume payment posting, and follow-up
- Exceptional data entry skills with verifiable accuracy in high-volume payment posting and complex claim updates
- Strong attention to detail and highly developed analytical and problem-solving skills
- Outstanding organizational and time management skills
- Professional written and verbal communication skills
- Understanding of and commitment to established procedures, guidelines, and regulatory requirements
- Proactive, solution-oriented, and leadership-driven approach to resolving billing issues
- Demonstrated experience mentoring and supporting junior team members
Benefits:
- 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
- Well-being perks and activities
- Surprise swag
- Regular community celebrations
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