Payer Integration Specialist

Posted Yesterday
Be an Early Applicant
Hiring Remotely in United States
Remote
85K-117K Annually
Mid level
Healthtech • HR Tech
We are revolutionizing how people find and receive mental health care.
The Role
Coordinate health plan integrations, translating payer requirements into eligibility, claims, billing, and automated workflow configurations. Serve as the primary liaison among payers, customers, and internal Sales, Product, Engineering, Billing Operations, and Customer Success teams. Implement and troubleshoot integrations, manage project plans and milestones, support annual benefit updates, maintain data integrity, and proactively resolve risks and issues.
Summary Generated by Built In
About Lyra Health
Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra’s transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions.

Importance of the Role: Support Lyra Health as it grows market share with Employers, Health Plans and Health Systems.

Our Payer Integration team at Lyra Health is seeking a Payer Integration Specialist to help expand access to life-changing mental health care. You'll join a highly collaborative, supportive team leading successful health plan integrations and configuring RCM system rules for seamless carrier connectivity. This role focuses on translating health plan requirements into automated workflows that manage custom network exceptions and eliminate billing friction.

What You'll Do:

  • Coordinate with payers to establish technical and operational connectivity

  • Translate payer-specific requirements into actionable implementation steps for internal teams

  • Focus on the day-to-day coordination with payers to establish technical and operational connectivity for standard integrations 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 team and external stakeholders

  • Implement, configure, and troubleshoot health plan and health systems technical integrations

  • Work closely with Sales, Product, Engineering, Payer Billing Operations and Customer Success to ensure alignment throughout the customer journey

  • Manage project plans, timelines and milestones to ensure timely and accurate delivery

  • Assist with the execution of annual benefit updates throughout the customer lifecycle to maintain data integrity

  • Participate in other projects as directed

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

"We are an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information or any other category protected by law.
 
By applying for this position, you acknowledge that your personal information will be processed as per the Lyra Health Workforce Privacy Notice. Through this application, to the extent permitted by law, we will collect personal information from you including, but not limited to, your name, email address, gender identity, employment information, and phone number for the purposes of recruiting and assessing suitability, aptitude, skills, qualifications, and interests for employment with Lyra.  We may also collect information about your race, ethnicity, and sexual orientation, which is considered sensitive personal information under the California Privacy Rights Act (CPRA) and special category data under the UK and EU GDPR.  Providing this information is optional and completely voluntary, and if you provide it you consent to Lyra processing it for the purposes as described at the point of collection, for example for diversity and inclusion initiatives.  If you are a California resident and would like to limit how we use this information, please use the Limit the Use of My Sensitive Personal Information form.  This information will only be retained for as long as needed to fulfill the purposes for which it was collected, as described above. Please note that Lyra does not “sell” or “share” personal information as defined by the CPRA. Outside of the United States, for example in the EU, Switzerland and the UK, you may have the right to request access to, or a copy of, your personal information, including in a portable format; request that we delete your information from our systems; object to or restrict processing of your information; or correct inaccurate or outdated personal information in our systems. These rights may be subject to legal limitations. To exercise your data privacy rights outside of the United States, please contact [email protected]. For more information about how we use and retain your information, please see our Workforce Privacy Notice."

Skills Required

  • 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, or similar healthcare integrations
  • Experience with Asana and Salesforce
  • Strong project management skills, including managing multiple workstreams and competing priorities
  • Exceptional communication skills and ability to work cross-functionally with technical and non-technical stakeholders
  • Ability to navigate ambiguity, anticipate risks, and proactively drive issues to resolution
  • Ability to collaborate across internal teams while leading and supporting multiple stakeholders
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The Company
HQ: Burlingame, CA
590 Employees
Year Founded: 2015

What We Do

Lyra Health’s mission is to transform mental health care through technology with a human touch — to get more patients the care they need when they need it. If you are an engineer or data scientist who would like to join in this effort, please reach out.

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