Out-of-Network Medical Billing and Appeals Specialist - Plastic Surgery

Medical Billing Specialist

Our established plastic surgery practice in San Francisco, led by a board-certified plastic surgeon, is growing and we're expanding our billing team to keep pace with increasing case volume. We're looking for an experienced Medical Billing Specialist who takes pride in clean claims, persistent follow-up, and getting the practice paid accurately for the care it provides.

This is a hands-on, in-office role on a small, close-knit team. You'll work directly with our front desk, clinical staff, and leadership, and you'll own key parts of the revenue cycle from claim submission through resolution.

Please submit your CV with a cover letter sharing a little bit about yourself, we would love to learn more about you!

What You'll Do

• Manage the full claims lifecycle (submission, follow-up, and resolution) for surgical and in-office procedures
• Verify eligibility and interpret benefits for commercial PPO plans, including out-of-network (OON) coverage
• Work denied and underpaid claims, identify root causes, and prepare insurance appeals
• Communicate with payers by phone and through payer portals to move claims to resolution
• Track claims, A/R, and follow-up activity in Excel and our practice management system
• Partner with the front desk and clinical team to capture accurate information up front and prevent denials
• Support patient billing questions and cost estimates as needed
• Participate in the full revenue lifecycle and engage in revenue recovery including, but not limited to the No Surprises Act IDR arbitration.

What You Bring

Required

• 3+ years of medical billing experience, preferably in surgical specialties or private practice
• Experience managing claims end to end, including denials, underpayments, and appeals
• Strong working knowledge of CPT, ICD-10, and HCPCS coding for surgical procedures
• Experience with all forms of insurance plans, eligibility verification, and benefits interpretation
• Experience with out-of-network billing, or the ability to learn OON workflows and reimbursement strategies quickly
• Experience with EMR/EHR and billing or practice management systems
• Proficiency in Microsoft Office, especially Excel
• Ability to work on-site full-time, with strong attendance and reliability

Nice to Have

• Experience in plastic surgery, cosmetic procedures, or cash-pay settings
• Experience with patient billing or cost estimates
• CPC or similar certification

Who You Are

• Detail-oriented and accurate, even when the volume is high
• Organized and able to juggle many claims and deadlines at once
• A persistent problem-solver who knows when to escalate
• A clear, professional communicator with payers, patients, and coworkers
• Independent and proactive, but a true team player who welcomes feedback

Compensation & Benefits

• Salary: $80,000 $90,000 per year, based on experience
• Performance-based bonus opportunities
• Health, Dental and Vision Insurance
• 401(k) with employer match
• 2 weeks Paid Time Off and Paid Holidays

How to Apply

Please submit your resume and a cover letter outlining your relevant experience and your interest in this role.

Please do not call the office. We review every application and will contact candidates selected for interviews.

We are an equal opportunity employer and value diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, ancestry, age, disability, medical condition, genetic information, marital status, veteran status, or any other characteristic protected by law. Pursuant to the San Francisco Fair Chance Ordinance and the California Fair Chance Act, we will consider for employment qualified applicants with arrest and conviction records.