Senior Analyst, First Level Appeals

Responsibilities

• Assess denied claims for appealability and select correct supporting documents
• Submit appeals through appropriate channels to recover revenue
• Document all actions, outcomes, and case notes accurately in the system of record
• Surface recurring denial patterns and payer-specific issues to improve accuracy
• Review system-generated outputs to support automation efforts
• Ensure compliance with payer policies, timely filing requirements, and regulatory guidelines
• Meet daily throughput and quality targets

Requirements

• 1+ year of experience in medical billing, claims processing, or appeals management in an RCM environment
• Working understanding of common denial categories like bundling, modifier, medical necessity, and timely filing
• Familiarity with payer policies, payer portals, and EHR systems
• Strong written communication and comprehension skills
• Strong reasoning skills to evaluate claim denials and determine resolution paths

About the Company

Commure is building the AI Operating System for healthcare, providing a platform that spans the full care journey from Ambient AI to autonomous RCM processing. The company supports over 500,000 clinicians and handles billions in annual claims.