Sr. Billing Operations Associate

Lyra Health

2d • $68,000 - $103,500

About The Position

Lyra Health is seeking a detail-oriented Senior Billing Operations Associate to support the Health Plan Billing Operations team’s accounts receivable function. The role focuses on accurate, timely processing of claim denials and payments from health plan partners. The associate independently handles complex billing work, helps optimize workflows, supports junior team members, and contributes to improvements in a growing healthcare organization.

Requirements

• At least 5 years of progressively responsible experience in healthcare billing, including independently managing complex claim denials, payment posting, and remittance reconciliation.
• Expertise interpreting complex EOBs and electronic remittance advice (ERAs) to resolve challenging billing issues.
• In-depth understanding of the claim lifecycle, claim-denial causes, resolution strategies, and payer-specific rules and regulations.
• Extensive experience navigating payer portals and using billing software for claim research, high-volume payment posting, and follow-up.
• Exceptional data-entry skills and a consistent record of accurate payment posting and claim-information updates.
• Strong attention to detail, analytical skills, and problem-solving ability to identify payment discrepancies and denial patterns.
• Strong organizational and time-management skills; ability to independently prioritize complex workloads and meet demanding deadlines.
• Effective written and verbal communication skills for professional, clear interactions with payers and internal teams.
• Commitment to established procedures and guidelines, with the ability to identify and recommend process improvements.
• Proactive, solution-oriented approach and ability to independently identify, analyze, and resolve complex billing issues.
• Experience mentoring and supporting junior team members.

Responsibilities

• Manage complex queues involving claim denials, payment posting, and remittance reconciliation.
• Analyze Explanation of Benefits (EOBs) and remittance advice (RAs) to identify causes of denials and payment discrepancies and determine resolutions.
• Investigate denied claims, correct errors, and ensure claims are resubmitted accurately and promptly to payers.
• Post high-volume, complex health plan payments to patient accounts, reconcile postings with bank deposits, and identify systemic posting errors.
• Identify and resolve discrepancies between expected and actual payments, escalating novel or high-impact issues.
• Follow up on outstanding denials and underpayments using payer portals, phone communication, and written correspondence.
• Prepare supporting documentation for appeals based on denial reasons and payer-specific processes and regulations.
• Maintain accurate, organized billing-system records and support data integrity and audit readiness.
• Collaborate with the team to manage queues and resolve complex billing issues, while supporting and serving as an escalation point for junior team members.
• Follow and promote standard operating procedures, compliance guidelines, regulatory requirements, and best practices.
• Identify complex denial and reconciliation issues, develop potential solutions, and recommend them to senior team members.
• Identify trends in denials and payment discrepancies and propose and implement process improvements.
• Mentor and guide junior team members and support their professional development.

Benefits

• Comprehensive healthcare coverage, including medical, dental, vision, FSA/HSA, life, and disability insurance.
• Coaching and therapy services through Lyra for Lyrians.
• Discretionary restricted stock units.
• Paid vacation, sick days, and company holidays.
• Paid parental leave.
• 401(k) with up to 3% matching.
• Monthly tech allowance.
• Well-being perks and activities, surprise swag, and regular community celebrations.
• The role may be eligible for discretionary bonuses.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed