[Urgent Search] Senior Analyst, First Level Appeals
3 weeks ago
Job Description
OverviewApplication
At Commure, our mission is to simplify healthcare. We have bold ambitions to reimagine the healthcare experience, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans ambient AI clinical documentation, provider copilots, autonomous coding, revenue cycle management and more all designed for providers & administrators to focus on what matters most: providing care.
Healthcare is a $4.5 trillion industry with more than $500 billion spent annually on administrative costs, and Commure is at the heart of transforming it. We power over 500,000 clinicians across hundreds of care sites nationwide more than $10 billion flows through our systems and we support over 100 million patient interactions. With new product launches on the horizon, expansion into additional care segments, and a bold vision to tackle healthcare's most pressing challenges, our ambition is to move from upstart innovator to the industry standard over the next few years.
Commure was recently named to Fortune's Future 50 list for 2025 and is backed by world-class investors including General Catalyst, Sequoia, Y Combinator, Lux, Human Capital, 8VC, Greenoaks Capital, Elad Gil, and more. Commure has achieved over 300% year-over-year growth for the past two years and this is only the beginning. Healthcare's moment for AI-powered transformation is here, and we're building the technology to power it. Come join us in shaping the future of healthcare.
The Appeals Submissions Team Member is responsible for managing and resolving appeals related to claims discrepancies. The ideal candidate will have a strong understanding of the healthcare billing and reimbursement process, excellent analytical skills, and a keen eye for detail.
Key Responsibilities
- Track Appeal Status: Monitor the progress of submitted appeals, follow up as necessary, and ensure timely resolution.
- Maintain Records: Accurately document all appeal activities, outcomes, and communications in the company's system.
- Identify Trends: Analyse denial patterns and provide feedback to improve claim submission processes and reduce future denials.
- Compliance: Ensure all appeals and related activities comply with relevant regulations, policies, and guidelines.
Qualifications
- Education: Bachelor's degree in healthcare administration, business, or a related field. Equivalent experience may be considered.
- Experience: Minimum of 2 years of experience in medical billing, claims processing, or appeals management within an RCM environment.
Skills
- Strong understanding of healthcare billing, coding, and reimbursement processes.
- Excellent analytical and problem-solving skills.
- Ability to interpret and apply complex regulations and guidelines.
- Proficient in using healthcare management software and databases.
- Strong written and verbal communication skills.
- Detail-oriented with strong organisational skills.
- Ability to work independently and as part of a team.
Commure + Athelas is committed to creating and fostering a diverse team. We are open to all backgrounds and levels of experience, and believe that great people can always find a place. We are committed to providing reasonable accommodations to all applicants throughout the application process.
Please be aware that all official communication from us will come exclusively from email addresses ending in @getathelas.com, @commure.com or @augmedix.com. Any emails from other domains are not affiliated with our organization.
Employees will act in accordance with the organization's information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. Employees will be required to attest to these requirements upon hire and on an annual basis.
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