Medical Biller

Description:

We are hiring an experienced Revenue Cycle Management (RCM) professional for a specialized Plastic Surgery, Cosmetic Surgery & Aesthetic practice (Massachusetts, USA-based billing environment).

This role requires strong expertise in US healthcare billing, payer compliance, and specialty surgical revenue cycles, including gender-affirming care billing (required).

Key Focus Areas

• Plastic Surgery / Cosmetic Surgery / Specialty Surgical billing (preferred)
• Gender-affirming care billing (required)
• Harvard Pilgrim Health Care & Sigma insurance workflows (required)
• Prior authorizations, AR follow-up, denial management, and appeals
• In-network & out-of-network reimbursement workflows
• ERA/EOB posting, claims tracking, and revenue recovery

Requirements

• Strong experience in US Healthcare RCM / Medical Billing
• Gender-affirming care billing (required)
• Harvard Pilgrim Health Care & Sigma insurance workflows (required)
• Deep understanding of payer rules, CPT/ICD-10 workflows, and medical necessity
• Experience handling high-value surgical claims
• Familiarity with Nextech EMR preferred
• Strong English communication and ownership mindset