Qureos Mentor

WellPsyche Medical Group

<div><h3 class="jobSectionHeader"><b>Description</b></h3><div><br>
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Behavioral Health | Government &amp; Commercial Payers | Lean Growth Organization | Remote</b><br>
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<b>WellPsyche Medical Group</b> is a leading telehealth behavioral health organization providing high-quality outpatient mental health services to children, adolescents, and adults across the United States.<br>
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As a <b>fully remote organization</b>, our team collaborates to expand access to compassionate mental health care while continuously improving the technology and systems that support patient care.<br>
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We are a <b>lean and fast-growing organization</b>, 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></div><div><br>
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<h3 class="jobSectionHeader"><b>Key Responsibilities</b></h3><div><br>
The <b>Claims Follow-Up Lead</b> is a senior, hands-on revenue cycle professional responsible for resolving complex denials, accelerating accounts receivable, and supporting daily claims workflow execution.<br>
</div><div>This is a <b>working lead role &mdash; not a full people management position</b> &mdash; designed for someone who can both execute independently and elevate the performance of the follow-up team.<br>
</div><div>The ideal candidate is experienced in <b>behavioral health billing, government payers, and high-volume claims follow-up</b>, and thrives in a fast-moving, accountability-driven environment.</div><br>
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What we seek from you</b></h3><div><b><br>
1. High-Complexity Claims Resolution (Primary Function)</b></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><b>2. A/R Performance Impact</b></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><b>3. Workflow Leadership</b></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>
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<b>What Success Looks Like</b>
</div><ul><li>Reduced 90+ day A/R</li>
<li>Increased appeal overturn rate</li>
<li>Improved clean claim rate</li>
<li>Faster payer response cycles</li>
<li>Clear communication of payer issues</li></ul><div><br>
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Required Experience</b></div><ul>
<li>3&ndash;5+ years behavioral health claims follow-up</li>
<li>Strong government payer experience</li>
<li>Experience in high-volume, multi-state billing</li>
<li>Ability to work independently in a remote setting</li>
<li>Comfortable in a startup environment with evolving processes</li>
</ul><div><b>WORKING CONDITIONS/PHYSICAL REQUIREMENTS:</b></div><div><b>
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This is a currently a 100% remote role. Must have a home office free from distractions and private for HIPAA purposes, and be available during work hours via Zoom, Chat, phone and other communication methods.</div><div></div><h3 class="jobSectionHeader"><b><br>
Benefits</b></h3><div><br>
We believe exceptional professionals thrive when they are supported, valued, and given the flexibility to do their best work. That&rsquo;s why we&rsquo;ve created a work environment designed to support both your career growth and your personal well-being.<br>
</div><ul><li><b>100% Remote Work</b> &ndash; Enjoy the flexibility of working from home while eliminating commute time and costs.<br>
</li><li><b>Technology Support</b> &ndash; We provide a company computer along with <b>partial internet reimbursement</b> to ensure you have the tools you need to succeed.<br>
</li><li><b>Comprehensive Health Benefits</b> &ndash; Access to competitive health insurance plans designed to support your overall well-being.<br>
</li><li><b>Paid Time Off</b> &ndash; We believe rest and personal time are essential for maintaining balance and preventing burnout.<br>
</li><li><b>Work/Life Balance</b> &ndash; Our culture prioritizes flexibility, respect, and sustainable workloads.<br>
</li><li><b>Career Growth</b> &ndash; As our organization continues to expand, we offer meaningful opportunities for <b>professional development and advancement</b>.<br>
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<b>Position Type:</b> Full-Time | 100% Remote<br>
</div><div> 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.</div><br>
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About WellPsyche</b></h3><div>
WellPsyche is a physician-run leader in Telepsychiatry, providing quality therapy and psychiatric services for children, adolescents, and adults striving to achieve mental health and wellness and reach their full potential.</div></div>

Claims Follow-Up Lead-CA

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WellPsyche Medical Group

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Claims Follow-Up Lead-CA