Job Description

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 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.
Job Overview:
We seek an experienced and highly motivated Senior Analyst to join our team. The Senior Analyst in Denials Management Team will be responsible for identifying denied claims, making outbound calls to insurance payers, and resubmitting corrected claims. The ideal candidate should possess excellent communication and problem-solving skills, have a strong understanding of medical billing and coding, and be well-versed in denial management and appeals processes.
Role & responsibilities
Denial Identification and Analysis: Identify, categorize, and analyze denials and underpayments from Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs).
Claim Resubmission: Correct and resubmit denied claims following payer guidelines and timelines.
Payer Communication: Communicate with insurance companies to resolve issues leading to denials and ensure accurate reimbursement.
Preventative Action: Review denial trends and work with other RCM teams to implement processes that can prevent future denials.
Experience in analyzing and resubmitting Denials in multiple specialities (Denials due to Medical Coding, Authorisation, etc).
Preferred candidate profile
1-3 years of prior experience in denials management, healthcare billing, or a related role.
Strong understanding of medical billing processes payer requirements and CARC/RARC codes.
Excellent problem-solving and negotiation skills.
Detail-oriented with strong analytical skills.
Excellent communication skills, both written and verbal.
Proficiency in using healthcare billing software and Microsoft Office Suite.
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 @ , @ or @ . 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.

Skills Required