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Claims Resolution Specialist

Burlingame, California · Provider Network Ops · Full-time
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About Lyra Health
Lyra is transforming mental health care through technology with a human touch to help people feel emotionally healthy at work and at home. We work with industry leaders, such as Morgan Stanley, Uber, Amgen, and other Fortune 500 companies, to improve access to effective, high-quality mental health care for their employees and their families. With our innovative digital care platform and global provider network, 10 million people can receive the best care and feel better, faster. Founded by David Ebersman, former CFO of Facebook and Genentech, Lyra has raised more than $900 million.

About the Role

Lyra Health is looking for a highly motivated individual to join our Billing Operations team as a Claims Resolution Specialist. This person will be responsible for collecting payments on outstanding balances from payers and ensuring timely reimbursement. This position requires updating status claims via payer portals, online platforms, email and/or telephone and performing appeals when necessary to recover reimbursement for denied claims.

Responsibilities

  • Uses assertive follow-up techniques with payers to drive claims resolution
  • Identifies denial reasons with abilities to decipher and take appropriate next steps to resolve
  • Identifies trends and generate create ideas for increasing efficiency of existing processes
  • Conducts timely and accurate follow up with payer with the goal of collecting reimbursement for outstanding claims
  • Displays sound judgment in choosing the most effective method of follow up
  • Resubmits corrected claims for reprocessing
  • Effectively communicates verbally and in writing with payers to bring claim resolution
  • Follows standard operating procedures and workflow documentation 
  • Manages sensitive information and strictly maintain HIPAA compliance
  • Follows up with clients regarding the status of their claims
  • Meets daily productivity goals
  • Contributes as an effective team member with a problem solving collaborative approach

Qualifications

  • 2 years of experience in healthcare billing or claims follow-up
  • Ability to read and understand EOBs
  • Comfortable communicating with patients and payers
  • Ability to flourish in a fast-paced, rapidly changing environment
  • Excellent attention to detail
  • Knowledge in government claims billing and reimbursement is a plus

This role is a remote opportunity. Qualified candidates located outside of California are welcome to apply! Candidates who include a cover letter will be prioritized.

We are an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability,  genetic information or any other category protected by law.

Apply now