Medical Claims Follow-Up Specialist

ALTER MANAGEMENT•Dana Point, CA

11d•$26 - $31•Onsite

About The Position

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.

Requirements

High School Diploma or GED required
2+ years of medical insurance claims/collections experience required
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
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

Nice To Haves

Behavioral health experience preferred
CollaborateMD experience preferred

Responsibilities

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
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
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
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