Insurance A/R Follow-Up Specialist, Plastic Surgery

RCM Staff LLC

. Call insurance companies to check claim status and resolve unpaid or underpaid claims .

Posted 11/2/2026full-timeRemote • California • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in U.S. healthcare insurance follow-up, including claim status inquiries and prior authorizations, while ensuring compliance with HIPAA regulations. Proficient in managing multiple patient accounts with strong attention to detail and effective communication skills.

Highest-signal resume keywords

U.S. Healthcare Insurance Follow-UpClaim Status InquiriesPrior AuthorizationsAttention To DetailPayer Portals Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claim Status ResolutionInsurance VerificationDenial ManagementMedical Necessity DocumentationAging A/R Reports ManagementSurgical Prior AuthorizationsCommercial Insurance FamiliarityGovernment Health Plans FamiliarityPatient Eligibility VerificationDocumentation Skills

Soft Skills

Strong Written CommunicationStrong Spoken CommunicationIndependent WorkFollow-Up SkillsTime Management

Tools & Technologies

Payer PortalsClaim Status ToolsStediInsurance Websites

Industry Keywords

HIPAA CompliancePlastic Surgery SupportReconstructive Surgery SupportCalifornia Insurance Plans

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

Remote work arrangement
Full-time schedule of 40 hours per week