Senior Analyst, Denial Management (India) at Commure

Gurugram, Haryana, India

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

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
Experience in analyzing and resubmitting denials in multiple specialties (e.g., denials due to medical coding, authorization)
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

Responsibilities

Identify, categorize, and analyze denials and underpayments from Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs)
Correct and resubmit denied claims following payer guidelines and timelines
Communicate with insurance companies to resolve issues leading to denials and ensure accurate reimbursement
Review denial trends and work with other RCM teams to implement processes that prevent future denials
Identify denied claims and make outbound calls to insurance payers

Skills

Key technologies and capabilities for this role

Denial ManagementMedical BillingMedical CodingClaims ProcessingInsurance AppealsOutbound CallingProblem-SolvingCommunication

Questions & Answers

Common questions about this position

What experience is required for the Senior Analyst, Denial Management role?

The role requires 1-3 years of prior experience in denials management, healthcare billing, or a related role, along with experience in analyzing and resubmitting denials in multiple specialties such as those due to medical coding or authorization.

What are the key responsibilities of this position?

Responsibilities include identifying and analyzing denied claims from EOBs and ERAs, correcting and resubmitting claims, communicating with insurance payers to resolve issues, and reviewing denial trends to implement preventative processes.

What skills make an ideal candidate for this role?

Ideal candidates have a strong understanding of medical billing processes, payer requirements, and CARC/RARC codes, plus excellent problem-solving, negotiation, analytical, and communication skills while being detail-oriented.

Is this a remote position or does it require working from an office?

This information is not specified in the job description.

What is the salary or compensation for this role?

This information is not specified in the job description.

Commure

Healthcare technology for data integration and safety

About Commure

Commure focuses on improving the healthcare industry by providing technology solutions that connect and empower healthcare workers. Its main product, CommureOS, is a lightweight operating system that integrates various healthcare technologies and datasets, helping providers streamline workflows and enhance patient care by delivering critical insights when needed. Additionally, Commure offers Commure Strongline, a discreet wearable badge that allows healthcare staff to quickly call for help, improving safety in potentially dangerous situations. This badge was developed with input from frontline workers and security experts to meet the specific needs of healthcare environments. Commure serves hospitals, clinics, and other healthcare facilities through a software-as-a-service (SaaS) model, charging subscription fees for access to its products. The company's goal is to create a more connected and safe healthcare ecosystem, ultimately enabling healthcare providers to deliver better care.

San Francisco, CaliforniaHeadquarters

2017Year Founded

$745.2MTotal Funding

GROWTH_EQUITY_VCCompany Stage

Enterprise Software, HealthcareIndustries

201-500Employees

Benefits

Unlimited Paid Time Off

Health Insurance

Dental Insurance

Vision Insurance

Parental Leave

Risks

Increased competition in AI scribe technology may pressure market share and pricing.

Integration of Memora Health's platform may face alignment challenges with existing systems.

Free AI scribe offering might strain resources if not monetized effectively.

Differentiation

CommureOS integrates disparate healthcare datasets, enhancing decision-making and operational efficiency.

Commure Strongline badge improves staff safety with rapid emergency alerts.

Commure's AI-powered scribe tool automates documentation, saving providers significant time.

Upsides

Acquisition of Augmedix enhances AI medical documentation, improving clinical decision-making.

Merger with Athelas creates a $6B healthcare infrastructure company, expanding resources.

Free AI scribe tool offers competitive advantage by broadening technology accessibility.

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