Operations Analyst, RCM Posting
4 days ago
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 Fortune's Future 50 list for 2025 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.
*Overview:*
Healthcare providers enter the medical field to care for patients, but administrative burdens often take away valuable time that could be spent on patient care. Augmedix is dedicated to transforming healthcare operations by streamlining workflows, enhancing efficiency, and reducing administrative overhead through advanced technology. By leveraging AI-powered solutions, workflow automation, and data-driven insights, we help providers stay connected with their patients and focus on delivering high-quality care.
We are seeking an Operations Analyst to join our growing Revenue Cycle Management (RCM) team. This role is critical in identifying, analyzing, and resolving medical claim remittances across multiple payers and specialties. The ideal candidate will have strong expertise in managing remit posting within RCM and resolving complex ledger discrepancies—leveraging mathematical reasoning and analytical skills to ensure accuracy and efficiency.
Duties and Responsibilities (but are not limited to):
- Study the payment ledgers of assigned encounters, verifying them through payer portals/ calls, and completing assigned daily targets in a timely manner.
- Flagging blockers and edge cases that deviate from known patterns judiciously in designated channels.
- Swift navigation of claim details as well as site info (Client information dashboard) to search up information necessary for verifying payments.
- Researching CPT codes, Denial codes, and adjustment codes to decipher complicated ledgers and deduce correct actions items to close/finalize the encounter.
- Review and interpretation of Explanation of Benefits (EOBs), Electronic Remittance Advice (ERAs), and LCD/NCD coverage guidelines through payer portal navigation.
- Maintain updated knowledge of CMS, Medicare, Medicaid, and commercial payer requirements.
- Collaborate with other teams and brainstorm to resolve posting related issues that affect revenue recognition through Slack channels and Linear ticket updates.
- Contribute to internal posting runbooks, SOPs, and reference documentation.
Job Requirements:
Educational Qualifications:
- Bachelor's degree in Healthcare Administration, Business/Accounting, Mathematics, Finance, CSE, 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 remit management is preferred.
- 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, identify patterns of payment, and resolve flagged encounters due to problematic ledgers and unresolved balances.
- Learn to navigate through various payer portals and search claim remittances with adequate functional speed.
- Ability to build, add, or edit retool dashboards and analyze big data using SQL.
- Comfortable using Microsoft Excel, Google Sheets, and Notion.
- Moderate level user experience in Slack and Linear or other product management tools.
Soft Skill Requirements:
- Excellent written and verbal communication skills to interact with cross-functional teams and overseas stakeholders to explain complex posting cases.
- Comfortable talking to US insurance representatives over calls while inquiring about claims.
- Detail-oriented with a proactive problem-solving approach.
- Comfortable using mathematical reasoning to identify mismatched ledgers.
- 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:
- Thorough understanding of US healthcare and relevant medical billing systems.
- Exposure to Medicare, Medicaid, and commercial payer workflows.
- Familiarity with maintaining or contributing to a posting runbook or appeals log.
- Comfort with financial/RCM datasets..
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.
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