Claims Follow-Up Lead-CA
WFA Digital Insight
The demand for skilled claims follow-up professionals in the healthcare sector has seen significant growth, with a 25% increase in job postings over the past year. As the healthcare industry continues to shift towards telehealth services, companies like WellPsyche Medical Group are at the forefront, providing high-quality outpatient mental health services. With the rise of remote work, professionals with expertise in behavioral health billing and government payers are in high demand. This role stands out for its focus on lean growth and process improvement, making it an attractive opportunity for those looking to make a meaningful impact in a fast-paced environment. Candidates should be prepared to showcase their analytical skills and experience with high-volume claims follow-up.
Job Description
About the Role
The Claims Follow-Up Lead role at WellPsyche Medical Group is a senior, hands-on position responsible for resolving complex denials, accelerating accounts receivable, and supporting daily claims workflow execution. As a fully remote organization, the team collaborates to expand access to compassionate mental health care while continuously improving the technology and systems that support patient care. The ideal candidate will thrive in a fast-moving, accountability-driven environment and have experience in behavioral health billing, government payers, and high-volume claims follow-up.The role entails working closely with the follow-up team to elevate performance and executing independently to resolve complex denials. The successful candidate will be a subject-matter expert for junior follow-up staff, assisting with daily work allocation and prioritization, and supporting productivity and quality standards.
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 lean and fast-growing organization, every team member plays a meaningful role in improving operations, strengthening revenue cycle performance, and supporting the mission to help patients become the best version of themselves.
What You Will Do
- Follow up on denied, underpaid, and aged behavioral health claims
- Work complex government payers, including Medi-Cal/Medicaid, Medicare, and VA Community Care
- 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 a 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
What We Are Looking For
- 3-5+ years of experience in 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
- Analytical and problem-solving skills
- Excellent communication and interpersonal skills
- Ability to work in a fast-paced environment
- Familiarity with HIPAA regulations
Nice to Have
- Experience with electronic health records (EHRs) and practice management systems (PMS)
- Knowledge of medical billing software and claims processing systems
- Certification in medical billing or a related field
Benefits and Perks
- 100% remote work
- Comprehensive health benefits
- Paid time off
- Career growth opportunities
- Flexible work schedule
- Partial internet reimbursement
- Company-provided computer
How to Stand Out
- Be prepared to showcase your experience with high-volume claims follow-up and government payers
- Highlight your analytical and problem-solving skills, as well as your ability to work independently in a remote setting
- Familiarize yourself with the company's values and mission, and be prepared to discuss how you can contribute to them
- Make sure your resume and cover letter are tailored to the role and highlight your relevant experience and skills
- Research the company and the industry to stay up-to-date on the latest trends and developments
- Be prepared to ask questions during the interview, such as what a typical day looks like in the role or what opportunities there are for career growth and professional development
This is a remote position listed on WFA Digital, the platform for professionals who work from anywhere. Browse more remote jobs across all categories.