Senior Billing Operations Associate

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as a subject matter authority in claim denials, payment posting, and remittance reconciliation.

• Oversee intricate billing queues and enhance workflows.

• Examine EOBs and RAs to pinpoint root causes of denial and payment discrepancies.

• Research, rectify, and resubmit denied claims to payers.

• Record high-volume health-plan payments to patient accounts and reconcile them with bank deposits.

• Detect and resolve differences between anticipated and actual payments.

• Pursue denials and underpayments via payer portals, phone communication, and written correspondence.

• Prepare documentation for intricate appeals.

• Ensure accurate billing-system records and maintain audit readiness.

• Collaborate on queue management and address complex billing challenges.

• Assist and escalate issues for junior team members.

• Comply with SOPs, regulatory guidelines, and compliance requirements.

• Suggest solutions and improvements to processes.

• Recognize trends in denial and payment discrepancies.

• Mentor and assist junior team members.

⛳️ Requirements

• At least 5 years of progressively responsible experience in healthcare billing.

• Proven expertise in independently managing complex claim denials, payment posting, and detailed remittance reconciliation.

• Subject matter proficiency in reading and interpreting intricate Explanation of Benefits (EOBs) and electronic remittance advice (ERAs).

• In-depth understanding of the entire claim lifecycle, claim denials, resolution methods, and payer-specific regulations.

• Experience navigating complex payer portals and utilizing billing software for claim research, high-volume payment posting, and follow-up.

• Exceptional data entry capabilities with proven accuracy in high-volume payment postings and complex claim updates.

• Strong attention to detail along with advanced analytical and problem-solving skills.

• Excellent organizational and time management abilities.

• Professional written and verbal communication skills.

• Knowledge of and commitment to established procedures, guidelines, and regulatory standards.

• Proactive, solution-oriented mindset, demonstrating leadership in resolving billing issues.

• Proven experience in mentoring and supporting junior team members.

🏝️ Benefits

• Comprehensive healthcare coverage (including medical, dental, vision, FSA/HSA, life and disability insurance).

• Lyra for Lyrians; coaching and therapy services.

• Equity in the company through discretionary restricted stock units.

• Competitive paid time off 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.