Billing Specialist

Job not on LinkedIn

🔥 30 minutes ago

🇵🇭 Philippines – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

📊 Billing Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 25%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Catena

WebsiteLinkedInAll Job Openings

1 - 10 employees

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

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

• Work denial queues daily in Candid and resolve claims through appeal or correction • Draft and submit appeals for denied claims and track them to resolution • Fix pre-submission blockers such as incorrect NPI setup, missing payer IDs, and provider enrollment gaps • Correct claim data and resubmit claims to improve the clean claim rate • Identify root causes of recurring denials and implement preventive fixes • Submit prior authorizations through the internal authorization dashboard, primarily for Medicaid plans • Track authorization status and follow up with payers until requests are approved or denied • Share authorization decisions with providers and the scheduling team • Contact patients or families when authorizations require additional details or documents • Update KPI dashboards for days in A/R, claim turnaround time, and clean claim rate • Send regular updates on backlog status and denial trends • Identify denial and authorization patterns and recommend process or system changes • Report to the Head of RCM and work with little day-to-day oversight • Reduce the current backlog of 1,000–2,500 items and improve A/R days, claim turnaround time, and clean claim rate

🎯 Requirements

• 2–5 years of provider-side healthcare revenue cycle experience at a practice, clinic, or outpatient provider; 3+ years preferred • Hands-on denials management experience, including working denial queues, drafting appeals, and resubmitting corrected claims • Hands-on prior authorization experience, including submitting requests, tracking status, and following up with payers • Experience with at least one clearinghouse or RCM platform, such as Candid Health, Waystar, Availity, Change Healthcare, Office Ally, or similar • Working knowledge of denial codes, NPI, payer IDs, and provider enrollment requirements • Prior ownership of a denial or authorization queue with measurable results • C2 English (CEFR) for phone calls with patients, families, and insurance payers • Medicaid billing and prior authorization experience preferred • Pediatric therapy billing experience preferred • CPT coding and EOB/ERA reading experience preferred • Team lead, supervisor, or trainer experience on a billing or RCM team preferred • Startup or high-growth healthcare practice experience preferred

🏖️ Benefits

• Competitive Salary: Based on experience and skills • Fully remote work from anywhere in the Philippines • Team incentives and recognition for maintaining 100% CRM hygiene and on-time reporting • Generous PTO in accordance with company policy • HMO coverage after 3 months for full-time employees based in the Philippines • Direct mentorship from international industry experts • Ongoing access to learning and development resources • Global networking opportunities

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