Billing Manager – Plastic Surgery Practice

Position Summary

The Billing Manager will oversee all aspects of the practice’s revenue cycle and accounts receivable, ensuring accuracy, timeliness, and compliance. This role requires strong knowledge of both cosmetic and insurance-based billing processes, plastic surgery coding, excellent communication skills, and the ability to work closely with patients, providers, insurance companies, and internal team members.  Knowledge and understanding of the Federal IDR process and the NSA (No Surprises Act) is required.  Interfacing with attorney firms specializing in physician advocacy litigation and the IDR process is a significant part of this role.

Key Responsibilities

Insurance & Authorization Management

• Verify eligibility and benefits
• Run prior authorizations for procedures and services
• Initiate pre-determinations as needed
• Update surgical insurance status forms
• Gather all supporting documents necessary for claims and approvals
• Compose insurance appeals and follow through until resolution

Billing, Coding & Payments

• Process coding packets and post charges
• Generate HCFA forms
• Post EFTs, checks, and all patient and insurance payments
• Create adjustment packets and adjust claims as appropriate
• Generate itemized statements and monthly billing statements
• Process claim recoupments and refunds
• Manage accounts receivable and follow up on outstanding claims
• Create and manage internal financial agreements
• Adjust surgical balances as required
• Send overdue accounts to collections

Administrative & Patient-Facing Duties

• Schedule PTP (provider-to-provider or pre-treatment planning) appointments as needed
• Provide patients with clear, compliant Good Faith Estimates
• Work with attorneys regarding negotiations and medical record requests
• Provide medical records to patients as requested
• Educate our staff on billing policies
• Monitor, credential, and maintain provider enrollment with payers

Qualifications

• Minimum 3–5 years of medical billing experience (plastic surgery or specialty surgical practice preferred)
• Certified Professional Coder or similar certification required
• Strong understanding of cosmetic vs. reconstructive billing workflows
• Proficiency in insurance verification, coding, prior authorizations, and appeals
• Experience with EHR/PM systems and electronic claims submission
• Excellent attention to detail, communication skills, and problem-solving abilities
• Ability to manage multiple priorities and work independently
• Proficiency in Microsoft Office (particularly Word and Excel) is required
• Experience with Nextech and Epic is preferred

Benefits

• Competitive salary (DOE)
• Health, dental, and vision benefits
• PTO and paid holidays
• Supportive, team-oriented environment
• Annual discretionary bonus