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Pearl TalentRemote Billing Specialist
Pearl Talent is seeking a remote Billing Specialist to support a fast-growing US pediatric speech therapy practice. Because patient volume has outpaced the internal billing team,…
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About This Role
Pearl Talent is seeking a remote Billing Specialist to support a fast-growing US pediatric speech therapy practice. Because patient volume has outpaced the internal billing team, the practice is separating its revenue cycle operations into distinct front-of-house and back-of-house positions. This individual will manage the back-of-house functions, focusing primarily on denials management and prior authorizations. Most operational duties will take place within the Candid clearinghouse and an internal authorization dashboard,…
Job Description
Pearl Talent is seeking a remote Billing Specialist to support a fast-growing US pediatric speech therapy practice. Because patient volume has outpaced the internal billing team, the practice is separating its revenue cycle operations into distinct front-of-house and back-of-house positions. This individual will manage the back-of-house functions, focusing primarily on denials management and prior authorizations. Most operational duties will take place within the Candid clearinghouse and an internal authorization dashboard, operating during Pacific Standard Time hours from Monday to Friday.
The person in this role will function with minimal daily supervision under the guidance of the Head of RCM. The primary objective is to reduce a substantial current backlog of items, improve claim turnaround times, lower days in accounts receivable, and increase the clean claim rate. This opportunity is suited for a professional with established provider-side revenue cycle experience who can independently handle complex billing queues and maintain precise reporting metrics.
Responsibilities
- Process daily denial queues in Candid by investigating issues and executing appeals or corrections
- Prepare and submit claim appeals and monitor them through to final resolution
- Resolve pre-submission blockers including missing payer IDs, NPI setup errors, and provider enrollment gaps
- Correct billing data and resubmit claims to maximize the clean claim rate
- Investigate root causes of recurring billing denials to implement permanent preventative fixes
- Submit and track prior authorizations utilizing an internal dashboard, primarily for Medicaid plans
- Communicate authorization outcomes to providers and the internal scheduling team
- Reach out to patients and families when additional documentation or details are needed for authorizations
- Maintain KPI dashboards tracking clean claim rates, claim turnaround times, and days in accounts receivable
- Deliver routine updates regarding denial patterns, trends, and backlog status to leadership
Requirements
- Two to five years of provider-side healthcare revenue cycle experience at a clinic, practice, or outpatient provider
- Demonstrated hands-on experience handling denial queues, writing appeals, and resubmitting corrected claims
- Practical background in submitting, tracking, and following up on prior authorizations
- Familiarity with at least one RCM platform or clearinghouse such as Candid Health, Waystar, Availity, Change Healthcare, or Office Ally
- Understanding of denial codes, NPI setups, payer IDs, and provider enrollment rules
- Prior experience owning a denial or authorization queue with verifiable performance outcomes
- C2 English proficiency on the CEFR scale for conducting telephone conversations with payers, patients, and families
Qualifications
- Prior billing and authorization experience specific to Medicaid plans
- Background in billing for pediatric therapy disciplines including speech, occupational, or physical therapy
- Experience reading EOBs and ERAs alongside CPT coding knowledge
- Previous experience acting as a team lead, trainer, or supervisor within a billing or RCM environment
- Background working in a startup or rapid-growth healthcare organization
Core Skills
Benefits
- Competitive salary determined by individual skills and experience
- Fully remote work arrangement allowing completion of duties from anywhere
- Team incentives recognizing on-time reporting and CRM hygiene
- Generous paid time off aligned with company policy
- HMO health coverage for Philippines-based team members following three months of full-time employment
- Direct mentorship opportunities alongside international industry experts
- Ongoing access to professional development and learning resources
- Global networking opportunities with professionals worldwide
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, this is a fully remote role where you can work from anywhere, with working hours set in Pacific Standard Time from Monday through Friday.
What are the primary responsibilities of the Billing Specialist?
The role focuses heavily on managing daily denial queues in Candid, fixing pre-submission errors, drafting appeals, and submitting and tracking prior authorizations through an internal dashboard.
What level of experience is required for this role?
Candidates must have two to five years of provider-side healthcare revenue cycle experience, hands-on experience with denials and prior authorizations, familiarity with clearinghouse platforms, and C2 English proficiency.
What benefits are provided?
Benefits include competitive compensation, HMO health coverage for Philippines-based talent after three months, generous paid time off, team incentives, direct mentorship, and professional development resources.
Sample Interview Questions
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