Payer Integration Specialist

Job not on LinkedIn

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $85k - $117k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

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👻 Ghost score 12%

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Lyra Health

501 - 1000 employees

Founded 2015

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

💰 $235M Series F on 2022-01

Healthcare • Healthcare Insurance • SaaS

Lyra Health is a mental health company that partners with organizations to deliver comprehensive and effective global workforce mental health benefits. By providing evidence-based mental health care, Lyra Health boosts employee well-being and drives business impact. Their platform offers high-quality mental health support through a global network of professionals, utilizing AI matching technology to connect members quickly with suitable providers. Lyra Health serves families, couples, adults, and children, offering support for diverse mental health needs. Their programs aim to improve employee health, productivity, and reduce healthcare costs while providing a seamless member experience.

📋 Description

• Coordinate with payers to establish technical and operational connectivity • Translate payer-specific requirements into actionable implementation steps for internal teams • Coordinate day-to-day payer connectivity for standard integration systems • Serve as the primary point of contact for health plan integration setups, focusing on eligibility, claims, and billing workflows • Participate in customer and partner kickoff meetings and act as a liaison between internal teams and external stakeholders • Implement, configure, and troubleshoot health plan and health systems technical integrations • Collaborate with Sales, Product, Engineering, Payer Billing Operations, and Customer Success throughout the customer journey • Manage project plans, timelines, and milestones for timely and accurate delivery • Assist with annual benefit updates to maintain data integrity • Participate in other directed projects • Translate health plan requirements into automated workflows, manage custom network exceptions, and reduce billing friction • Configure RCM system rules for seamless carrier connectivity

🎯 Requirements

• 3+ years of work experience in a high-growth, fast paced environment • Deep understanding of health plan structures, payer operations, claims billing and utilization management workflows • Hands-on experience with RTE (270/271), claims (837), accumulators and/or similar healthcare integrations, preferably including systems like Asana and SalesForce • Strong project management skills with the ability to manage multiple work streams and competing priorities • Exceptional communication skills and the ability to work cross-functionally with technical and non-technical stakeholders • Comfortable navigating ambiguity, anticipating risks, and proactively driving issues to resolution • Passion for working in collaboration across internal teams, both leading and supporting multiple stakeholders

🏖️ Benefits

• Comprehensive healthcare coverage (including medical, dental, vision, FSA/HSA, life and disability insurances) • Lyra for Lyrians; coaching and therapy services • Equity in the company through discretionary restricted stock units • Competitive time off with pay policies including vacation, sick days, and company holidays • Paid parental leave • 401K with up to 3% matching • Monthly tech allowance • Well-being perks and activities • Surprise swag • Regular community celebrations

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