Medical Claims Follow-Up Specialist

Help Sustain Access to Care: Join Us as a Medical Claims Follow Up Specialist!

At Alter Behavioral Health, access to treatment doesn’t stop at admissions — it’s supported by strong, ethical revenue cycle operations. As a Medical Claims Collector, you play a critical behind-the-scenes role ensuring services are reimbursed accurately and on time so we can continue delivering high-quality, evidence-based mental health care.

If you’re organized, persistent, and experienced in medical collections — and you value professionalism and empathy in financial conversations — this role offers stability, impact, and growth from our corporate office in Dana Point.

Why You’ll Love This Role

• Mission-Driven Impact Support access to life-changing mental health treatment through strong revenue integrity
• Consistent Schedule Monday–Friday, 8:30 AM–5:00 PM
• Location Corporate Office in Dana Point, CA - In-Person Required
• Career Stability Full-time, hourly role with long-term growth potential
• Comprehensive Benefits Medical/Dental/Vision Insurance , PTO, CA Paid Sick Leave, Up to $50 Gym Reimbursement Monthly
• Invest in Your Future 401(k) with up to a 6% match

What You’ll Do

Collections & Accounts Receivable Management

• Perform daily collection activities on unpaid or delayed insurance and private pay accounts
• Actively manage and resolve aged AR (60/90/120+ days) in accordance with payer guidelines
• Communicate with insurance carriers, third-party payers, and private pay clients to resolve balances
• Confirm claim receipt, payment status, and reimbursement timelines
• Research non-payments, partial payments, and variances to determine resolution
Document all collection activity accurately in the billing system

Verification of Benefits & Eligibility Support

• Verify insurance benefits impacting reimbursement and patient responsibility
• Review deductibles, co-insurance, co-pays, and benefit limitations
• Identify coverage issues that may delay payment and escalate as needed
Partner with internal teams to resolve benefit-related payment barriers

Denials, Appeals & Escalations

• Track denial trends and follow up on appeal status and determinations
• Coordinate with billing, clinical, and RCM teams to resolve payer disputes
Support timely appeal submission and resolution

Patient Balance Collections & AR Support

• Manage and collect aged patient balances professionally and empathetically
• Communicate financial responsibility and payment options clearly
• Monitor assigned aging buckets and prioritize collection efforts
• Support AR cleanup initiatives and cash flow improvement projects

Who You Are

• Persistent, organized, and detail-oriented
• Professional and empathetic in financial conversations
• Comfortable managing high-volume AR and follow-ups
• Strong communicator with insurance carriers and patients
• Committed to confidentiality, compliance, and ethical standards
Team-oriented and solutions-focused

Minimum Qualifications & Requirements

• High School Diploma or GED required
• 2+ years of medical insurance claims/collections experience required
• Behavioral health experience preferred
• CollaborateMD experience preferred
• Experience working with insurance carriers, third-party payers, and private pay accounts
• Strong customer service and communication skills
• Ability to maintain HIPAA compliance
• Must pass a LiveScan criminal background check
• CPR & First Aid Certification required

Why Alter Behavioral Health?

• Mission-Driven Culture – Revenue integrity supports care, access, and long-term treatment outcomes
• Career Stability – Consistent schedule with full-time benefits
• Supportive Team Environment – Collaboration across Billing, RCM, and Clinical teams

At Alter Behavioral Health, every role supports recovery. As a Medical Claims Collector, your work helps ensure individuals can continue receiving the care they need — while keeping our operations compliant, ethical, and sustainable.

DISCLAIMER : This posting provides a general overview of the Medical Claims Follow Up Specialist role at Alter Behavioral Health. It is not a complete or exhaustive list of all responsibilities, duties, requirements, or conditions of employment. Specific job functions and expectations may be modified at the discretion of the company in accordance with business needs.

Alter Behavioral Health complies with all applicable federal, state, and local employment laws, including the California Labor Code, Industrial Welfare Commission (IWC) Wage Order 5, Fair Labor Standards Act (FLSA), and all laws relating to non-discrimination, equal opportunity employment, disability accommodation, and workplace safety.