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

Pacific Plastic Surgery Group•San Francisco, CA

10d•$80,000 - $90,000•Onsite

About The Position

We are an established plastic surgery practice in San Francisco led by a board-certified plastic surgeon, seeking an experienced Medical Billing Specialist to join our growing team. As our practice continues to expand, we are adding to our billing department to support increased case volume and ensure a high standard of revenue cycle management. Please include a cover letter with your application outlining your relevant experience and interest in this role. PLEASE DO NOT CALL THE OFFICE

Requirements

3+ years of medical billing experience, preferably in surgical specialties or private practice settings
Experience managing the full lifecycle of claims, including submission, follow-up, and resolution
Prior exposure to out-of-network billing or willingness to quickly learn OON workflows and reimbursement strategies
Strong working knowledge of CPT, ICD-10, and HCPCS coding related to surgical procedures
Experience with commercial insurance plans (PPOs), including eligibility verification and benefits interpretation
Understanding of common denial reasons and payer behavior, with the ability to take corrective action
Experience handling denied or underpaid claims and following through to resolution
Ability to assist with or independently prepare basic insurance appeals
Comfortable communicating with payers via phone and payer portals to resolve claims
Experience with EMR/EHR and billing or practice management systems
Proficiency in Microsoft Office, particularly Excel for tracking and organizing claims
Ability to work on-site full-time and collaborate closely with front desk, clinical staff, and leadership
Comfortable handling time-sensitive billing tasks in a structured, in-office environment
Strong attendance, reliability, and accountability
High attention to detail and accuracy
Strong organizational skills with the ability to manage multiple claims and priorities
Problem-solving mindset with the ability to identify and escalate issues when needed
Clear, professional communication skills
Able to work independently while also contributing to a small, team-oriented practice
Proactive and dependable, with a willingness to take ownership of assigned workflows
Open to feedback and continuous improvement