Denials Operations Associate
Athelas
At Athelas and Commure, we're bringing simple, life-changing health care products and medical billing services to people around the globe.
In addition to our established Remote Patient Monitoring business, we introduced a rapidly expanding SaaS Revenue Cycle Management solution in 2022 that provides revenue intelligence for hundreds of healthcare businesses from small clinics to large health systems. Our state-of-the-art dashboard, Athelas Insights, provides practices with an unparalleled understanding into their financial health to help them with all aspects of RCM, including eligibility, rejections, denials, as well as coding optimization and more.
To keep pace with our remarkable momentum - having seen a 5x increase in revenue over the past 6 months with more exponential growth on the horizon - we're actively seeking new, high-impact team members looking for a challenge!
Commure and Athelas have recently joined forces to form healthcare’s next-generation operating system. Through its pioneering AI-powered platform, the newly combined Commure gives time back to clinicians and staff at hospitals and health systems across the U.S. with easy-to-use clinical, financial, and operational solutions.
Together, we’re on a mission to connect, protect, and empower healthcare by developing groundbreaking and hyper-connected technologies. We believe deeply that by joining our many datasets and digital solutions together in harmony, we can solve our industry’s biggest challenges: improving the experiences of our care providers, bringing down the cost of care, and ensuring the health and wellbeing of our communities.
Combined, Commure and Athelas is backed by General Catalyst, Sequoia, Y Combinator, Lux, Human Capital, 8VC, Greenoaks Capital and Elad Gil.
If you want to improve healthcare innovation through close partnerships between developers and doctors, come work with us!
About the Role
Our team is looking for a Junior Operations Associate who will be an essential part of our Denials Operations team. You will have end-to-end ownership - ensuring efficient execution and driving business metrics. This is an incredibly high-visibility, high-impact, high-autonomy role that will quickly expand to cover more and more emergent business problem areas. Successfully navigating and solving our hyper-growth challenges will lead to rapid growth in role and responsibility. There is no ceiling.
Location: Must be able to do hybrid work in our Lehi, Utah office.
What You’ll Do
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Claims Management:
Handle the end-to-end process of claims management, including submission, tracking, and resolution.
Proactively call payers to gather information, verify claim status, and address denials promptly.
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Denial Debugging:
Investigate and debug claim denials to identify root causes and develop effective resolution strategies.
Collaborate with internal teams to address recurring denial issues and implement preventive measures.
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Claim Resubmission:
Take ownership of the claims resubmission process, ensuring accuracy and compliance with payer requirements.
Develop a systematic approach to streamline the resubmission workflow and minimize errors.
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Metric Ownership:
Manage and own performance metrics for a designated subset of accounts.
Regularly analyze metrics, identify trends, and implement improvement strategies to enhance overall operational efficiency.
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Cross-Functional Collaboration:
Work closely with product teams to understand system functionalities and contribute to the development of tools that improve operational workflows.
Collaborate with engineers to address technical challenges and enhance the overall operations infrastructure.
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Continuous Improvement:
Actively seek opportunities for process improvement and efficiency gains within the operations workflow.
Provide feedback on existing processes and contribute ideas for enhancing overall team productivity.
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Documentation and Reporting:
Maintain accurate and detailed documentation of all interactions, resolutions, and updates related to claims and denials.
Generate regular reports on key performance indicators and present findings to the team.
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Communication Skills:
Effectively communicate with internal and external stakeholders, ensuring clarity and transparency in all interactions.
Collaborate with team members to share insights, best practices, and updates on payer policies.
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Compliance and Regulation:
Stay informed about changes in healthcare regulations and payer policies.
Ensure all operations activities adhere to compliance standards and guidelines.
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Team Collaboration:
Actively participate in team meetings, share insights, and contribute to a positive and collaborative team culture.
Assist team members as needed and foster a supportive and cohesive working environment.
Why You’ll Like Working with Athelas
Execution focused, driven team: Join a team with an incredible record - we are the smallest, fastest company in history to receive FDA hematology clearance. We are also the largest Remote Patient Monitoring company in the US, with a fast-growing SaaS Revenue Cycle Management business as well
Technology Focus: Revolutionizing how technology can be used in the healthcare industry
Strong Backing: $132M Series B raised from the likes of Sequoia, General Catalyst, Tribe, Y Combinator
Mission Driven: We are changing the way healthcare is provided, bringing it directly to the people who need it with technology-enabled solutions
Incredible Growth: Revenue growth of 5x over the past 6 months and we're just getting started!
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.
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.