Insurance A/R Follow-Up Specialist, Plastic Surgery
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Job Description
Insurance A/R specialist resolving unpaid claims, prior authorizations, and eligibility issues for a California plastic surgery practice. Remote full-time role supporting U.S. healthcare revenue cycle operations.
Responsibilities:
- Call insurance companies to check claim status and resolve unpaid or underpaid claims
- Work aging A/R reports and prioritize follow-up by balance and timely filing risk
- Follow up on pending prior authorizations until a decision is received
- Verify patient eligibility and benefits before scheduled procedures
- Check claim status through payer portals and the practice's claim status tools
- Identify denials and route them for correction, appeal, or resubmission
- Document every call and portal action clearly, including reference numbers and next steps
- Escalate stalled claims and authorizations to the practice billing team
- Protect patient information and follow HIPAA requirements
Requirements:
- At least 1 year of experience with U.S. healthcare insurance follow-up
- Experience calling payers on claim status and prior authorizations
- Familiarity with commercial insurance and government health plans
- Experience using payer portals and insurance websites
- Strong written and spoken English, with confidence on long payer calls
- Excellent attention to detail and follow-up skills
- Ability to work independently and manage multiple patient accounts
- Reliable internet connection and a suitable remote workspace
- Preferred: Experience supporting plastic surgery, reconstructive surgery, or other surgical practices
- Preferred: Experience with surgical prior authorizations and medical necessity documentation
- Preferred: Familiarity with California insurance plans such as Blue Shield of California
- Preferred: Experience using Stedi or similar claim status tools
- Must be available 8:00 AM to 4:30 PM Pacific Time
- Philippines-based applicants preferred
Benefits:
- Remote work arrangement
- Full-time schedule of 40 hours per week
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