What are the responsibilities and job description for the Out-of-Network Medical Billing and Appeals Specialist (Plastic Surgery) position at Pacific Plastic Surgery Group?
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**
Experience
- 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
Technical Knowledge
- 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
Appeals & Collections
- 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
Systems & Tools
- Experience with EMR/EHR and billing or practice management systems
- Proficiency in Microsoft Office, particularly Excel for tracking and organizing claims
In-Office Work Requirements
- 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
Skills & Attributes
- 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
Work Style
- 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
Nice to Have (Not Required)
- Experience in plastic surgery, cosmetic procedures, or cash-pay environments
- Familiarity with patient billing or cost estimates
- CPC or similar certification
Compensation:
- $80,000-90,000 annually, depending on experience
- Bonus opportunities based on performance
- Health insurance, paid time off, and paid holidays
Salary : $80,000 - $90,000