Senior Analyst, First Level Appeals

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. Why you’ll love working at Commure + Athelas Highly Driven Team: We work hard and fast for exceptional results, knowing we’re doing mission-driven work to transform the country’s largest sector. Strong Backing: We are backed by top investors including General Catalyst, Sequoia, Y Combinator, Lux, Human Capital, 8VC, Greenoaks Capital and Elad Gil. Incredible Growth: Prior to our merger, Commure and Athelas had independently grown more than 500% YoY for three consecutive years. We’ve achieved Series D funding, have an industry-leading runway, and continue to scale rapidly. Competitive Benefits: Flexible PTO (pending specific geographical locations) , medical, dental, vision, maternity and paternity leave. Note that benefits are subject to change and may vary based on jurisdiction.