Commure is looking for an Operations Analyst - Secondary Submission to join our Revenue Cycle Management team in Bangladesh. This detail-oriented and proactive role is critical in identifying, analyzing, and resolving medical claim denials across multiple payers and specialties.
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 We're Looking For
- Bachelor’s degree in Healthcare Administration, Business, Life Sciences, or a related field.
- 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.
- 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.
- 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.
Nice to Have
- Additional training or certifications in Medical Billing, CPC, or RCM fundamentals.
- Experience with Notion or similar documentation tools.
- 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.
Technical Stack
- Microsoft Excel
- Google Sheets
- EHR systems
- Clearinghouse platforms
- Notion
Team & Environment
You will be joining our growing Revenue Cycle Management (RCM) team, a highly driven group operating in a performance-driven environment.
Benefits & Compensation
- Flexible PTO
- Medical, dental, and vision coverage
- Maternity and paternity leave
Work Mode
This is an onsite position located in Bangladesh.
Commure + Athelas is committed to creating and fostering a diverse team. We are open to all backgrounds and levels of experience and are committed to providing reasonable accommodations to all applicants throughout the application process.
