Insurance A/R Follow-Up Specialist (CA, Plastic Surgery) at RCM Staff LLC

About this role

This is a remote position.
Job Summary RCM 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
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