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.
Medical Billing Specialist / Insurance Claims Verifier
Job not on LinkedIn
November 13
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
• Verify insurance eligibility and benefits using Availity and payer portals. • Contact insurance companies for coverage clarification and policy details. • Generate accurate cost estimates for evaluations and ongoing care. • Communicate estimates to families in a clear, supportive, and timely manner. • Confirm in-network status and coordinate with credentialing as needed. • Submit prior authorization and referral requests for services requiring approval. • Track authorization limits, expirations, and visit usage for ongoing treatment. • Communicate authorization status updates with providers and administrative staff. • Resubmit authorizations or follow up on pending determinations to prevent service disruption. • Enter and reconcile patient charges across two EMR systems. • Manage copays, co-insurance, and upfront evaluation payments. • Resolve claim errors that prevent submission and address payer denials. • Conduct denial research, correct claim issues, and resubmit as necessary. • Coordinate with clearinghouse and coding as needed and complete write-offs per policy. • Confirm provider notes are submitted on time and meet billing documentation standards. • Serve as the primary contact for patient billing questions via email/tickets. • Ensure responses are clear, empathetic, and consistent with billing policies.
🎯 Requirements
• Proven experience in medical billing, insurance verification, and claims processing. • Familiarity with CPT codes, coverage rules, authorizations, and denial workflows. • Comfortable communicating with insurance payers and families regarding billing matters. • Strong organizational skills with the ability to track multiple ongoing cases. • Ability to work independently and maintain consistent attention to detail. • Experience working in behavioral health, speech therapy, or outpatient clinic settings. • Experience using multiple EMRs simultaneously. • Background working in a fully remote operations environment. • Required: Availity (insurance verification), EMRs (ability to learn and manage multiple systems), Payer portals and claims submission platforms, Email and ticket-based communication systems. • Preferred: Candid or similar billing systems, Clearinghouse claim management platforms
🏖️ Benefits
• Competitive Salary: Based on experience and skills • Remote Work: Fully remote—work from anywhere • Performance Bonus: Based on data accuracy, reporting timeliness, and overall sales efficiency • Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting • Generous PTO: In accordance with company policy • Health Coverage for PH-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 • Global Networking: Connect with professionals worldwide
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