Operations Analyst

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.

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.

About The Role
We are seeking a
detail-oriented and proactive Operations Analyst
to join our growing
Revenue Cycle Management (RCM)
team. This role is critical in identifying, analyzing, and resolving medical claim denials across multiple payers and specialties. The ideal candidate will have a strong understanding of RCM workflows, denial codes, and payer policies—with a focus on root-cause resolution and long-term denial prevention.

What You'll Do

• Analyze and resolve denied medical claims, focusing on CARC/RARC codes and payer-specific denial reasons.
• Collaborate with coding, billing, and enrollment teams to identify and prevent recurring denial patterns.
• Review and interpret Explanation of Benefits (EOBs), Electronic Remittance Advice (ERAs), and LCD/NCD coverage guidelines.
• Work on denials related to modifiers, timely filing, COB, ICD/CPT mismatches, and medical necessity.
• Track resolution timelines, maintain denial logs, and contribute to denial dashboards and performance metrics.
• Assist in preparing appeals and resubmissions, ensuring accurate and compliant documentation.
• Maintain updated knowledge of CMS, Medicare, Medicaid, and commercial payer requirements.
• Contribute to internal denial runbooks, SOPs, and reference documentation.

What You Have
Educational Qualifications:

• Bachelor's degree in Healthcare Administration, Business, Life Sciences, or a related field.
• Additional training or certifications in Medical Billing, CPC, or RCM fundamentals is a plus.

Professional Experience

• 1–2 years of experience in medical billing or RCM, with a specialization in denial management.
• Hands-on experience with denial codes (CO, PR), modifiers, ICD-10/CPT coding, and CLIA compliance.
• Familiarity with EHR systems and clearinghouse platforms.
• Understanding of LCD/NCD policies and payer-specific coverage guidelines.

Technical And Analytical Skills

• Strong analytical abilities to investigate and resolve claim denial root causes.
• Ability to interpret and work with large volumes of claims data, remittance files, and denial reason codes.
• Comfortable using Microsoft Excel, Google Sheets, and reporting tools.
• Experience with Notion or similar documentation tools is a plus.

Soft Skill Requirements

• Excellent written and verbal communication skills to interact with cross-functional teams and explain complex denial cases.
• Detail-oriented with a proactive problem-solving approach.
• Capable of working both independently and collaboratively in a high-volume, performance-driven environment.
• High adaptability and eagerness to stay updated with payer policies and regulatory changes.

Preferred Skills

• Exposure to Medicare, Medicaid, and commercial payer workflows.
• Experience in appeal writing and supporting payer audits.
• Familiarity with maintaining or contributing to a denial runbook or appeals log

Details

• Work Shift: Night (On-site)
• Weekdays: Monday to Friday

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.