{"id":3762638,"url":"https://alion.io/job/catena-remote-billing-specialist","title":"Remote Billing Specialist","company":{"id":634,"name":"Catena","domain":"pearltalent.com","url":"https://alion.io/company/catena","size_band":"51-200","is_staffing_agency":true,"employer_type":"agency","is_intermediary":false,"listed_via":null,"ats_vendor":"Workable","truth_index":{"grade":"B","score":75,"open_postings":19,"ghost_share":0,"stale_share":1,"repost_share":0,"time_to_fill_p50_days":26,"computed_at":"2026-11-08T05:47:12Z"}},"role":"Finance","role_family":"Finance","seniority":null,"employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"posting_text","remote_working_hours":{"label":"PST","utc_offset_min":-8,"utc_offset_max":-8},"hiring_geo_confidence":"structured","locations":[],"countries":[],"hiring_countries":["PH"],"hiring_countries_total":1,"salary":null,"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"OpenAI","optional":false}],"status":"live","first_seen_at":"2026-11-04T19:05:03Z","employer_posted_date":"2026-11-04","last_verified_at":"2026-11-09T00:16:36Z","board_verified":true,"closed_at":null,"days_open":4,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":4},"description":"Work From Anywhere in the Philippines\nWork Schedule: PST | 8:00 AM - 4:00 PM, Monday to Friday\nAbout Pearl Talent\nPearl works with the top 1% of candidates from around the world and connects them with the best startups in the US and EU. Our clients have raised over $5B in aggregate and are backed by companies like OpenAI, a16z, and Founders Fund.\nHear why we exist, what we believe in, and who we’re building for:\nWatch here: https://www.loom.com/share/863b8e426e6d48309aa8f4ea4c1c94cd\nAbout the Client\nA fast-growing US pediatric speech therapy practice is looking for a Revenue Cycle Specialist to own denials management and prior authorizations on the provider side.\nPatient volume has grown faster than the current billing team can handle, so the practice is splitting its revenue cycle function into front-of-house and back-of-house roles. This hire owns the back-of-house side. Almost all of the practice’s authorizations go through Medicaid plans.\nAbout the Role\nAbout 70-80% of the work happens in the Candid clearinghouse. That includes appealing denied claims, fixing pre-submission issues like NPI setup and payer ID errors, and working the denial queue every day. The other 20-30% is submitting and tracking prior authorizations through an internal dashboard. Phone calls with patients, families, or payers happen occasionally, but most of the work is in the systems. The hire reports to the Head of RCM and works with little day-to-day oversight. Success means a shrinking backlog, which currently runs from 1,000 to 2,500 items, and better days in A/R, claim turnaround time, and clean claim rate.\nCore Responsibilities\nDenials Management & Claims Resolution\nWork denial queues daily in Candid and resolve each claim through appeal or correction.\nDraft and submit appeals for denied claims and track them to resolution.\nFix pre-submission blockers such as incorrect NPI setup, missing payer IDs, and provider enrollment gaps.\nCorrect claim data and resubmit claims to raise the clean claim rate.\nFind the root cause of recurring denials and apply fixes so they don’t happen again.\nPrior Authorization Submission & Tracking\nSubmit prior authorizations through the internal authorization dashboard, mostly for Medicaid plans.\nTrack authorization status and follow up with payers until each request is approved or denied.\nShare authorization approvals and denials with providers and the scheduling team.\nContact patients or families when an authorization needs more details or documents.\nReporting & Performance Monitoring\nUpdate the KPI dashboard for days in A/R, claim turnaround time, and clean claim rate.\nSend regular updates on backlog status and denial trends.\nFlag patterns in denials and authorizations and recommend process or system changes.\nRequirements\nMust-Have\n2-5 years of provider-side healthcare revenue cycle experience at a practice, clinic, or outpatient provider (3+ years preferred; payer-side only does not qualify)\nHands-on denials management experience: working denial queues, drafting appeals, and resubmitting corrected claims\nHands-on prior authorization experience: submitting requests, tracking status, and following up with payers\nExperience with at least one clearinghouse or RCM platform (Candid Health, Waystar, Availity, Change Healthcare, Office Ally, or similar)\nWorking knowledge of denial codes, NPI, payer IDs, and provider enrollment requirements\nOwnership of a denial or authorization queue in a prior role, with measurable results (e.g., backlog cleared, denial rate reduced, days in A/R lowered)\nC2 English (CEFR) for phone calls with patients, families, and insurance payers\nNice-to-Have\nMedicaid billing and prior authorization experience\nBilling experience for pediatric therapy services (speech, PT, or OT)\nCPT coding and EOB/ERA reading experience\nTeam lead, supervisor, or trainer experience on a billing or RCM team\nExperience at a startup or high-growth healthcare practice\nBenefits\n Competitive Salary: Based on experience and skills \n Remote Work: Fully remote-work from anywhere \nTeam Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting\nGenerous PTO: In accordance with company policy \nHealth Coverage for PH-based talents: HMO coverage after 3 months for full-time employees \n Direct Mentorship: Guidance from international industry experts \n Learning & Development: Ongoing access to resources for professional growth \n Global Networking: Connect with professionals worldwide \nOur Recruitment Process\n Application \n Screening \n Skills Assessment \n Topgrading Interview \n Client Interview \n Job Offer \n Client Onboarding\nReady to Join Us?\nIf you’re empathetic, organized, and passionate about improving patient experiences through operational excellence, this role is for you. Apply now to help make specialized healthcare more accessible to patients across the U.S.","description_format":"text","description_chars":4863,"description_truncated":false,"requirements":{"experience_years_min":null,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[{"language":"English","level":"Proficiency (C2)","optional":false}]},"benefits":[],"hiring_locations":[{"name":"Philippines","iso":"PH","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":[],"lifecycle":[{"event":"open","at":"2026-11-04T19:05:03Z"}],"visa":[],"liveness":{"score":38,"band":"fade","label":"Fading","p_open":1,"p_active":0.379,"p_room":1,"age_days":3,"expected_fill_days":26,"reasons":["conf:1","agency","stale_co","velocity","win:early"],"computed_at":"2026-11-08T05:47:12Z"},"pay":null,"html_url":"https://alion.io/job/catena-remote-billing-specialist","json_url":"https://alion.io/job/catena-remote-billing-specialist.json","meta":{"generated_at":"2026-11-09T02:40:15Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":138,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-10T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.1,"usd":0.01,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":634},"rest":"https://alion.io/mcp/rest/get_company?id=634"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fcatena-remote-billing-specialist"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":2,"usd":0.2},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fcatena-remote-billing-specialist"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.1,"usd":0.01},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fcatena-remote-billing-specialist"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/catena-remote-billing-specialist\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fcatena-remote-billing-specialist"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":3762638}},{"tool":"search_jobs","arguments":{"company":"pearltalent.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":3762638},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. 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