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Ringkasan Yukerja
Lowongan Claims Follow-Up Lead-CA di WellPsyche Medical Group kami kurasi dari Himalayas (kategori Kesehatan). Posisi ini ditandai sebagai remote — pastikan timezone dan syarat lokasi kandidat di deskripsi resmi. Yukerja.com bukan pemberi kerja — lamaran diproses di situs sumber resmi.
Claims Follow-Up Lead
Behavioral Health | Government & Commercial Payers | Lean Growth Organization | Remote
WellPsyche Medical Group is a leading telehealth behavioral health organization providing high-quality outpatient mental health services to children, adolescents, and adults across the United States.
As a fully remote organization, our team collaborates to expand access to compassionate mental health care while continuously improving the technology and systems that support patient care.
We are a lean and fast-growing organization, which means every team member plays a meaningful role in improving operations, strengthening revenue cycle performance, and supporting our mission to help patients become the best version of themselves.
Key Responsibilities
The Claims Follow-Up Lead is a senior, hands-on revenue cycle professional responsible for resolving complex denials, accelerating accounts receivable, and supporting daily claims workflow execution.This is a working lead role — not a full people management position — designed for someone who can both execute independently and elevate the performance of the follow-up team.The ideal candidate is experienced in behavioral health billing, government payers, and high-volume claims follow-up, and thrives in a fast-moving, accountability-driven environment.
What we seek from you
1. High-Complexity Claims Resolution (Primary Function)- Follow up on denied, underpaid, and aged behavioral health claims.
- Work complex government payers including:
- Medi-Cal / Medicaid (FFS & Managed Care)
- Medicare (Part B & Advantage)
- VA Community Care (TriWest / Optum)
- Submit appeals and corrected claims within timely filing limits.
- Escalate payer issues strategically and track resolution outcomes.
- Prioritize high-value and aging accounts.
- Identify denial trends and root causes.
- Proactively surface systemic billing issues to leadership.
- Contribute directly to cash flow improvement.
- Act as subject-matter expert for junior follow-up staff.
- Assist with daily work allocation and prioritization.
- Support productivity and quality standards.
- Participate in process improvements in a fast-moving environment.
- Possess qualities supporting the company values of people matter, compassionate leadership, mamba mentality, WOW service.
What Success Looks Like
- Reduced 90+ day A/R
- Increased appeal overturn rate
- Improved clean claim rate
- Faster payer response cycles
- Clear communication of payer issues
- 3–5+ years behavioral health claims follow-up
- Strong government payer experience
- Experience in high-volume, multi-state billing
- Ability to work independently in a remote setting
- Comfortable in a startup environment with evolving processes
Benefits
We believe exceptional professionals thrive when they are supported, valued, and given the flexibility to do their best work. That’s why we’ve created a work environment designed to support both your career growth and your personal well-being.- 100% Remote Work – Enjoy the flexibility of working from home while eliminating commute time and costs.
- Technology Support – We provide a company computer along with partial internet reimbursement to ensure you have the tools you need to succeed.
- Comprehensive Health Benefits – Access to competitive health insurance plans designed to support your overall well-being.
- Paid Time Off – We believe rest and personal time are essential for maintaining balance and preventing burnout.
- Work/Life Balance – Our culture prioritizes flexibility, respect, and sustainable workloads.
- Career Growth – As our organization continues to expand, we offer meaningful opportunities for professional development and advancement.
Position Type: Full-Time | 100% Remote Join a mission-driven organization where your work directly supports access to quality mental health care while helping strengthen and scale a high-performing revenue cycle team.
Originally posted on Himalayas