Progressive Insurance Jobs in Boca Raton, FL (NOW HIRING)

We are seeking an experienced Team Lead, Behavioral Health Insurance Collections Specialist to support advanced accounts receivable and payer collections activities within a high-volume mental health and substance use disorder treatment billing environment. This role will focus on complex insurance follow-up, denial resolution, appeals management, underpayment recovery, and receivables optimization, while also providing leadership and mentorship to collections team members.

The ideal candidate brings deep expertise in behavioral health revenue cycle management, including payer authorization structures, level-of-care billing, reimbursement troubleshooting, and appeals strategy across both mental health and addiction treatment services.

This is an excellent opportunity for a collections leader who thrives in a fast-paced environment, enjoys solving complex reimbursement challenges, and is passionate about improving financial performance through operational excellence.

Key Responsibilities

• Manage advanced insurance collections activities for outstanding claims with commercial, Medicaid, managed care, and behavioral health carve-out payers through phone outreach, payer portals, and written correspondence
• Investigate and resolve complex behavioral health claim denials, underpayments, zero-pay claims, reimbursement discrepancies, and authorization-related payment issues
• Develop and execute follow-up strategies on aging receivables to maximize recovery and maintain optimal AR performance
• Escalate high-priority claims and unresolved payer issues through provider relations, contract escalation channels, and payer leadership contacts when appropriate
• Identify recurring denial patterns tied to medical necessity, level of care, authorizations, utilization reviews, coding issues, and documentation gaps, then recommend corrective action
• Prepare and support appeals submissions, including medical necessity appeals, authorization appeals, retrospective review documentation, and payer-specific clinical documentation requests
• Coordinate responses to payer requests for treatment records, authorizations, utilization documentation, and letters of medical necessity
• Research payment variances and reconcile account balances accurately within billing systems
• Maintain detailed documentation of all collection activity, payer communication, escalations, and account resolution steps
• Monitor payer portals, remittance activity, and correspondence to ensure prompt follow-up on outstanding balances
• Mentor and support junior collections staff on payer processes, workflow management, escalation strategies, and collections best practices
• Assist leadership in monitoring AR aging, denial trends, recovery rates, and departmental performance metrics
• Maintain strict compliance with HIPAA, payer requirements, and revenue cycle best practices
• Participate in process improvement initiatives designed to strengthen collections performance and reduce outstanding AR

Qualifications

• Minimum 5+ years of progressive insurance collections experience within behavioral health, addiction treatment, or related specialty healthcare billing
• Direct experience collecting on mental health and substance use disorder claims is required
• Prior leadership experience in a Team Lead, Senior Specialist, Supervisor, or mentor-level collections capacity strongly preferred
• High School Diploma or equivalent required; Associate’s or Bachelor’s degree preferred
• Strong knowledge of behavioral health billing workflows, utilization review processes, payer authorization structures, and reimbursement methodologies
• Experience working complex denials involving medical necessity, authorization failures, documentation requests, and payer reimbursement disputes
• Familiarity with CPT / ICD coding concepts, behavioral health billing standards, and payer-specific reimbursement models
• Proficiency using billing systems, electronic health records, and payer portals
• Strong analytical, organizational, and problem-solving skills with ability to independently manage complex high-dollar accounts
• Excellent written and verbal communication skills with ability to professionally engage payers, provider relations teams, and internal stakeholders
• Ability to prioritize competing deadlines in a fast-paced, high-volume collections environment
• Proven ability to work independently while positively contributing to team performance and culture

Preferred Experience

• Experience billing and collecting across multiple behavioral health levels of care, including outpatient, intensive outpatient, partial hospitalization, residential, and detox services
• Strong understanding of commercial behavioral health plans, Medicaid managed care, and payer carve-out structures
• Advanced appeals experience with successful overturn strategies for complex denials
• Experience mentoring or overseeing collections staff in a leadership capacity
• Strong understanding of revenue cycle KPIs including AR days, aging buckets, denial trends, recovery rates, and reimbursement performance