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Medical Billing Specialist

Prism Health

We are seeking a full-time remote Medical Billing Specialist to support a U.S.-based plastic and reconstructive surgery practice. This role is best suited for someone with strong experience in healthcare billing, insurance follow-up, prior authorizations, claims management, and appeals. The ideal candidate should have excellent English communication skills, strong attention to detail, and the ability to work independently in a fast-paced specialty medical office environment. This position will support the practice by helping ensure that claims, authorizations, and insurance-related issues are handled accurately and efficiently. We are looking for someone who understands U.S. healthcare billing workflows and can confidently communicate with insurance companies, internal staff, and other stakeholders. Description Key Responsibilities: Manage day-to-day medical billing tasks for a plastic and reconstructive surgery practice. Submit, track, and follow up on insurance claims. Assist with prior authorization requests, including gathering required documentation and following up with payers. Contact insurance companies to resolve denied, delayed, or underpaid claims. Prepare and submit insurance appeals when needed. Review Explanation of Benefits, claim denials, and payer responses to determine next steps. Verify insurance coverage and benefits as needed. Maintain accurate billing records, documentation, and follow-up notes. Communicate clearly with the medical practice team regarding claim status, authorization updates, and outstanding issues. Support overall revenue cycle processes to help improve collections and reduce claim delays. Required Qualifications: Minimum of 3 years of experience in medical billing, prior authorization, insurance follow‑up, appeals, or a similar healthcare revenue cycle role. Strong understanding of U.S. medical billing and insurance processes. Experience working with insurance companies and payer portals. Knowledge of claims follow-up, denials management, and appeals processes. Excellent written and spoken English is required. Strong organizational skills and attention to detail. Ability to manage multiple tasks, follow up consistently, and meet deadlines. Prior experience supporting a U.S.-based medical practice. Preferred Qualifications: Experience with plastic surgery, reconstructive surgery, dermatology, cosmetic surgery, or other specialty practice billing. Familiarity with EMR/EHR or practice management systems. Experience with prior authorizations for procedures, surgeries, medications, or specialty services. Experience handling insurance appeals and documentation requests. Location: Candidates based in Latin America, the Philippines, or India are welcome to apply. Schedule: Full-time position. Candidate must be able to work with U.S., Central Standard business hours. #J-18808-Ljbffr Prism Health

Vacancy posted 4 days ago
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