Catena
HR Tech • Enterprise • Recruitment
Catena, now known as Pearl Talent, is a company that specializes in helping organizations hire top remote talent from overseas, primarily focusing on candidates from the Philippines and Latin America. They offer a rigorous vetting process to ensure they provide highly capable candidates equipped with modern software skills and fluent English proficiency. Pearl Talent provides two main hiring services: Managed Services, which handles compliance, payroll, and training, and Direct Placement for companies that manage hires internally. They focus on long-term retention and quality in their hiring processes, aiming to build high-performing remote teams for a range of industries including healthcare, real estate, and finance.
Billing Lead – Healthcare Operations, ABA RCM
Job not on LinkedIn
43 minutes ago
Catena
HR Tech • Enterprise • Recruitment
Catena, now known as Pearl Talent, is a company that specializes in helping organizations hire top remote talent from overseas, primarily focusing on candidates from the Philippines and Latin America. They offer a rigorous vetting process to ensure they provide highly capable candidates equipped with modern software skills and fluent English proficiency. Pearl Talent provides two main hiring services: Managed Services, which handles compliance, payroll, and training, and Direct Placement for companies that manage hires internally. They focus on long-term retention and quality in their hiring processes, aiming to build high-performing remote teams for a range of industries including healthcare, real estate, and finance.
📋 Description
• Oversee end-to-end billing for all credentialed ABA providers and clinics. • Review and submit clean claims across Medicaid, commercial, and Tricare plans. • Ensure accurate charge capture aligned with session logs, EVV data, and authorizations. • Monitor clearinghouse rejections and correct errors within 24–48 hours. • Manage denials, appeals, adjudications, and ongoing payer follow-up. • Post EOBs/ERAs and reconcile deposits consistently and accurately. • Oversee benefit checks, eligibility verification, and VOB workflows. • Manage initial and ongoing prior authorizations for all clients. • Track expiring authorizations and coordinate renewals with BCBAs and Intake teams. • Ensure alignment between authorization limits, units, and billing operations. • Maintain payer-specific rules across Medicaid, commercial, and Tricare. • Ensure CPT coding accuracy (97151, 97153, 97155, 97156), modifiers, and documentation compliance. • Collaborate with Product to resolve rule gaps and support billing automation improvements. • Build, mentor, and manage billing specialists as the function scales. • Develop SOPs, QA workflows, billing playbooks, and training materials. • Partner with operational teams on claim statuses, blockers, and expectations. • Work with Product/Engineering to enhance billing, posting, COB, and analytics tools. • Maintain dashboards covering cash collected, AR aging, denials, and claim status. • Identify trends, risk areas, and payer behavior changes. • Provide leadership visibility into revenue cycle health and performance metrics.
🎯 Requirements
• 3–5+ years of ABA medical billing or RCM experience. • Deep understanding of ABA coding, modifiers, EVV, Medicaid rules, and authorization workflows. • Experience supporting high-volume billing operations (20+ providers). • Excellent written communication and documentation discipline. • Ability to collaborate with engineering/design teams on tooling improvements. • High attention to detail, accuracy, and operational follow-through. • Ability to thrive in a fast-paced, scaling startup environment. • Experience with MSO structures or group NPI models. (Preferred) • Background scaling RCM operations or leading billing teams. (Preferred) • Familiarity with CO Medicaid, TX Medicaid, Tricare West, and multi-state commercial plans. (Preferred)
🏖️ Benefits
• Competitive Salary: Based on experience and portfolio quality • Remote Work: Fully remote—work from anywhere • Performance-Based Bonus: Based on creative quality and timely project delivery • Creative Growth: Long-term opportunity to lead major campaigns or projects • Generous PTO: In accordance with company policy • Health Coverage for Philippines-based talents: HMO coverage after 3 months for full-time employees • Direct Mentorship: Guidance from international industry experts • Learning & Development: Ongoing access to resources for professional growth
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