Insurance A/R Follow-Up Specialist (CA, Plastic Surgery)
TypeFull-time job
LocationPhilippines
Posted1 hour ago
This is a remote position.
Job SummaryRCM 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
Originally posted on Himalayas
Job SummaryRCM 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
Originally posted on Himalayas
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