<h3>Claims Follow-Up Lead</h3><div><strong><br>Behavioral Health | Government &amp; Commercial Payers | Lean Growth Organization | Remote<div><strong><br><a href="https://himalayas.app/companies/wellpsyche-medical-group">WellPsyche Medical Group</a></strong> is a leading telehealth behavioral health organization providing high-quality outpatient mental health services to children, adolescents, and adults across the United States.<div><br>As a <strong>fully remote organization</strong>, our team collaborates to expand access to compassionate mental health care while continuously improving the technology and systems that support patient care.<div><br>We are a <strong>lean and fast-growing organization</strong>, 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.<div><div><h3>Key Responsibilities</h3><div><div><br>The <strong>Claims Follow-Up Lead</strong> is a senior, hands-on revenue cycle professional responsible for resolving complex denials, accelerating accounts receivable, and supporting daily claims workflow execution.<div>This is a <strong>working lead role — not a full people management position</strong> — designed for someone who can both execute independently and elevate the performance of the follow-up team.<div>The ideal candidate is experienced in <strong>behavioral health billing, government payers, and high-volume claims follow-up</strong>, and thrives in a fast-moving, accountability-driven environment.</div><h3>What we seek from you</h3><div><div><strong>1. High-Complexity Claims Resolution (Primary Function)</strong></div><ul><li>Follow up on denied, underpaid, and aged behavioral health claims.</li><li>Work complex government payers including:<ul><li>Medi-Cal / Medicaid (FFS &amp; Managed Care)</li><li>Medicare (Part B &amp; Advantage)</li><li>VA Community Care (TriWest / Optum)</li></ul></li><li>Submit appeals and corrected claims within timely filing limits.</li><li>Escalate payer issues strategically and track resolution outcomes.</li></ul><div><strong>2. A/R Performance Impact</strong></div><ul><li>Prioritize high-value and aging accounts.</li><li>Identify denial trends and root causes.</li><li>Proactively surface systemic billing issues to leadership.</li><li>Contribute directly to cash flow improvement.</li></ul><div><strong>3. Workflow Leadership</strong></div><ul><li>Act as subject-matter expert for junior follow-up staff.</li><li>Assist with daily work allocation and prioritization.</li><li>Support productivity and quality standards.</li><li>Participate in process improvements in a fast-moving environment.</li><li>Possess qualities supporting the company values of people matter, compassionate leadership, mamba mentality, WOW service.</li></ul><div><strong><br>What Success Looks Like</strong></div><ul><li>Reduced 90+ day A/R</li><li>Increased appeal overturn rate</li><li>I