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

Medical Billing SpecialistOur 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 DoManage the full claims lifecycle (submission, follow-up, and resolution) for surgical and in-office proceduresVerify eligibility and interpret benefits for commercial PPO plans, including out-of-network (OON) coverageWork denied and underpaid claims, identify root causes, and prepare insurance appealsCommunicate with payers by phone and through payer portals to move claims to resolutionTrack claims, A/R, and follow-up activity in Excel and our practice management systemPartner with the front desk and clinical team to capture accurate information up front and prevent denialsSupport patient billing questions and cost estimates as neededParticipate in the full revenue lifecycle and engage in revenue recovery including, but not limited to the No Surprises Act IDR arbitration.What You BringRequired3+ years of medical billing experience, preferably in surgical specialties or private practiceExperience managing claims end to end, including denials, underpayments, and appealsStrong working knowledge of CPT, ICD-10, and HCPCS coding for surgical proceduresExperience with all forms of insurance plans, eligibility verification, and benefits interpretationExperience with out-of-network billing, or the ability to learn OON workflows and reimbursement strategies quicklyExperience with EMR/EHR and billing or practice management systemsProficiency in Microsoft Office, especially ExcelAbility to work on-site full-time, with strong attendance and reliabilityNice to HaveExperience in plastic surgery, cosmetic procedures, or cash-pay settingsExperience with patient billing or cost estimatesCPC or similar certificationWho You AreDetail-oriented and accurate, even when the volume is highOrganized and able to juggle many claims and deadlines at onceA persistent problem-solver who knows when to escalateA clear, professional communicator with payers, patients, and coworkersIndependent and proactive, but a true team player who welcomes feedbackCompensation & BenefitsSalary: $80,000 – $90,000 per year, based on experiencePerformance-based bonus opportunitiesHealth, Dental and Vision Insurance401(k) with employer match2 weeks Paid Time Off and Paid HolidaysHow to ApplyPlease 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.