Insurance A/R Follow-Up Specialist, Plastic Surgery

This is a fully remote position, open to applicants in California.

📋 Description

• Contact insurance providers to verify claim status and address unpaid or underpaid claims.

• Manage aging accounts receivable reports and prioritize follow-ups based on balance and timely filing risks.

• Pursue pending prior authorizations until a decision is achieved.

• Confirm patient eligibility and benefits before scheduled procedures.

• Check claim status using payer portals and the practice's claim status tools.

• Identify denials and direct them for correction, appeal, or resubmission.

• Accurately document each call and portal action, including reference numbers and next steps.

• Elevate stalled claims and authorizations to the practice billing team.

• Safeguard patient information and adhere to HIPAA regulations.

⛳️ Requirements

• Minimum of 1 year of experience in U.S. healthcare insurance follow-up.

• Experience in contacting payers regarding claim status and prior authorizations.

• Familiarity with commercial insurance and government health plans.

• Proficient in using payer portals and insurance websites.

• Strong written and verbal English skills, with confidence in handling lengthy payer calls.

• Exceptional attention to detail and follow-up abilities.

• Capability to work independently and manage multiple patient accounts.

• Reliable internet connection and an appropriate remote workspace.

• Preferred: Experience in supporting plastic surgery, reconstructive surgery, or other surgical practices.

• Preferred: Background in surgical prior authorizations and medical necessity documentation.

• Preferred: Knowledge of California insurance plans such as Blue Shield of California.

• Preferred: Experience with Stedi or similar claim status tools.

• Must be available from 8:00 AM to 4:30 PM Pacific Time.

• Preference given to applicants based in the Philippines.

🏝️ Benefits

• Opportunity for remote work.

• Full-time schedule of 40 hours per week.