About Richmond Aesthetic Surgery

At Richmond Aesthetic Surgery and Dermlounge we enhance lives through personalized aesthetic and surgical care, delivering exceptional results with compassion and expertise. Our values of excellence, service, and respect reverberate through all we do! As the premier aesthetic surgery practice in Central Virginia, we are renowned for transformative results, exceptional patient experiences, and pioneering advancements in the field.

About the role:

As the Insurance and Medical Billing Specialist you play a pivotal role as your expertise directly contributes to the success of our busy plastic surgery practice and ensures a positive financial experience for our patients. Your responsibilities include obtaining authorizations for surgery and office visits, sending claim forms through our clearinghouse, following up on claims, appealing claims, and handling accounts receivables. You are a proactive problem-solver and a key liaison between patients, our clinical team, and insurance carriers. Your day is dynamic: from meticulously verifying patient eligibility and securing pre-authorizations to expertly navigating the complexities of claim submissions and appeals. You'll be empowered to investigate discrepancies, implement corrective actions for denied claims, and ensure the accurate posting of payments.

What you'll do:

• Ensure a smooth patient experience by meticulously verifying insurance eligibility and benefits, and navigating pre-authorization requirements.
• Champion accurate and timely reimbursement by expertly preparing and submitting medical claims for specialized plastic surgery procedures.
• Become a problem-solving expert by investigating and skillfully appealing denied claims, identifying root causes to implement lasting solutions.
• Maintain financial integrity by accurately posting insurance payments and adjustments within our practice management system.
• Drive revenue cycle success through persistent and professional follow-up on outstanding claims and unpaid balances.
• Build strong collaborative relationships by communicating effectively with insurance companies to resolve billing discrepancies and secure proper reimbursement.
• Empower patients by working alongside our Patient Care Insurance and Surgery Coordinator to clarify insurance coverage, financial responsibilities, and payment options.
• Serve as a knowledgeable resource by assisting patients directly with their billing and insurance inquiries, ensuring clarity and peace of mind.
• Serve as liaison with claims management firm when necessary to optimize healthcare reimbursement and collections.
• Stay at the forefront of your field by maintaining up-to-date knowledge of CPT, ICD-10, and HCPCS coding guidelines specific to plastic surgery.
• Navigate the evolving healthcare landscape by staying informed about changes in insurance regulations and payer policies, especially the No Surprises Act.
• Contribute to continuous improvement by generating and analyzing billing reports to identify trends, resolve issues, and uncover opportunities for enhancement.
• Foster accuracy and compliance by collaborating with our clinical staff to ensure documentation robustly supports all billing.
• Uphold the highest ethical standards by maintaining strict confidentiality of all patient information.
• Deliver service excellence daily, meeting and exceeding the expectations of both our team members and our valued patients.
• Shape our operational success by contributing to and adhering to best practices in office and insurance administration.
• Embrace growth and teamwork by supporting organizational changes with a positive outlook, all while championing our core practice values of excellence, service, and respect.
• Be an integral team player by performing other administrative duties as assigned to support the overall success of the practice.

Qualifications:

• High school diploma or equivalent is required. Associate's degree in medical billing, healthcare administration, or a related field preferred.
• Minimum of three years of experience as an insurance specialist with a demonstrated understanding of the in and out of network insurance claim submission processes, denials, and appeals.  A bachelor’s degree may substitute for some experience.
• At least 1 year in a plastic surgery, dermatology, or similar surgical specialty practice is highly preferred.
• Proficiency with practice management software, electronic health records (EHR) systems, TriZetto and Availity or similar insurance clearinghouses . Experience using NexTech is preferred.
• Excellent written and verbal communication skills and strong attention to detail and accuracy are required.
• Strong problem-solving and analytical abilities are essential.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) is required.
• Knowledge of HIPAA regulations is required.

Why choose us?

• Be part of a renowned aesthetic surgery practice.
• Work alongside a team of dedicated professionals.
• Enjoy competitive compensation and benefits.
• Grow your career in a supportive environment.

Compensation for this full-time, in-office, non-exempt position is based on experience, with a target hiring range of $23 to $33 per hour. In addition to hourly pay, employees are eligible for an annual performance-based bonus. RAS offers a comprehensive benefits package that includes health and dental insurance, a 401(k) plan, paid holidays, paid time off, and bereavement leave.

Please be sure to attach an updated resume. Cover letters outlining your interest and qualifications are encouraged!