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.

About The Role:

- We're seeking a Denials Team Lead with hands-on experience across both inpatient and outpatient denials to drive overturns, reduce aged inventory, and prevent recurrence at the root cause.

- You'll lead a pod of denial analysts, set daily priorities, coach for quality and speed, and collaborate with Coding, Charge Entry, Registration, and Payer Relations to improve first-pass yield and cash acceleration.

Key Responsibilities:

Team Leadership & Delivery:

- Lead a team of denial analysts across IP/OP workqueues; plan capacity, assign work, and monitor performance.

- Run daily huddles; set targets for productivity, quality, and TAT; remove blockers and manage escalations.

- Conduct 1:1s, coaching, cross-training, and performance reviews.

Denials Resolution:

- Review EOB/ERA, CARC/RARC codes, payer policies, and medical necessity criteria to build strong appeals.

- Oversee timely filing, resubmissions, corrected claims, and second-level medical appeals.

- Drive overturns on common IP denials (level of care, lack of medical necessity, DRG changes) and OP denials ( bundling, NCCI edits, MUEs, modifiers, prior auth).

Quality, Analytics & Prevention:

- Own team KPIs: denial-to-resolution TAT, aged bucket reduction (- 90/120), first-pass acceptance, and QA.

- Perform root-cause analysis by payer/denial reason/service line; partner with Coding to fix upstream leakage.

- Maintain SOPs and payer playbooks; run calibration with QA.

Compliance & Documentation:

- Ensure HIPAA compliance, accurate account notes, and audit-ready documentation.

- Track and meet payer-specific TATs and timely filing limits.

- Commure 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.