About Lyra Health
Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra’s transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions.
About the Role
Lyra is seeking a detail-oriented Billing Associate to support our Health Plan Billing Operations Teams accounts receivable (A/R) function. In this role, you’ll be responsible for performing key billing functions to ensure accurate and timely processing of claim denials and payments from our health plan partners.. This is an excellent opportunity to contribute to a growing team and develop your skills in a dynamic healthcare environment.
What You'll Do
- Serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation, independently managing complex queues and demonstrating advanced understanding of workflow optimization.
- Expertly analyze Explanation of Benefits (EOBs) and remittance advice (RAs) to identify intricate root causes of denials or payment discrepancies, developing effective resolution strategies.
- Proactively take ownership of complex denied claims, conducting in-depth investigations, independently correcting intricate errors, and ensuring accurate and timely resubmission of claims to payers.
- Independently manage the accurate and efficient posting of high-volume and complex payments from health plans to patient accounts, ensuring precise allocation, thorough reconciliation with bank deposits, and proactive identification of systemic posting errors.
- Expertly identify, analyze, and independently resolve complex discrepancies between expected and actual payments, escalating only the most novel and high-impact issues.
- Lead proactive follow-up on outstanding denials and underpayments through expert utilization of payer portals, sophisticated phone communication, and clear, persuasive written correspondence.
- Independently prepare comprehensive and well-supported documentation for complex appeals based on nuanced denial reasons, demonstrating a thorough understanding of payer-specific appeal processes and regulations.
- Maintain meticulous and expertly organized records of all actions taken within the billing system, ensuring the highest level of data integrity and audit readiness.
- Collaborate strategically with team members to optimize efficient queue management, proactively contribute to the timely resolution of complex billing issues, and serve as a point of escalation and support for junior team members.
- Consistently adhere to and champion established Standard Operating Procedures (SOPs) and compliance guidelines, demonstrating a deep understanding of regulatory requirements and best practices.
- Proactively identify complex denial or reconciliation issues and independently develop potential solutions, presenting well-reasoned recommendations to senior team members.
- Lead the identification of trends in denials and payment discrepancies, proactively proposing and implementing significant process improvements within your area of expertise.
- Provide mentorship, guidance, and support to junior team members, fostering their professional development and contributing to the overall knowledge and skill level of the team.
What You'll Bring
- A minimum of 5 years of progressively responsible experience i