Insurance A/R Follow-Up Specialist (CA, Plastic Surgery)

Job Summary

RCM Staff BPO is hiring a full-time Insurance A/R Follow-Up Specialist to support a plastic and reconstructive surgery practice based in California.

The specialist calls insurance companies and works payer portals daily to resolve unpaid claims, follow up on prior authorizations, and confirm patient coverage, documenting every outcome clearly. This role requires strong phone communication, consistent follow-up, and hands-on experience working with U.S. health insurance plans.

Key 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

Qualifications

* 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 Qualifications

* Experience supporting plastic surgery, reconstructive surgery, or other surgical practices

* Experience with surgical prior authorizations and medical necessity documentation

* Familiarity with California insurance plans such as Blue Shield of California

* Experience using Stedi or similar claim status tools

Schedule

* Full-time position, 40 hours per week

* Must be available 8:00 AM to 4:30 PM Pacific Time

* Final schedule will be determined based on practice needs

Work Arrangement

* Remote

* Philippines-based applicants preferred