{"id":3978170,"url":"https://alion.io/job/catena-remote-rcm-specialist","title":"Remote RCM 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":"2026-11-09T06:03:00Z"}},"role":"Finance","role_family":"Finance","seniority":null,"employment_type":"full_time","work_mode":"remote","remote_scope":"stated_regions","remote_scope_basis":"posting_text","remote_working_hours":{"label":"PST","utc_offset_min":-8,"utc_offset_max":-8},"hiring_geo_confidence":"inferred","locations":["Bogotá, Colombia","Medellín, Colombia","Mexico City, Mexico"],"countries":["CO","MX"],"hiring_countries":["AR","BR","CO","MX","PH","AI","AG","AW","BS","BB","BZ","BM","BO","VG","BQ","KY","CL","CR","CW","DM","DO","EC","SV","FK","GF","GD","GP","GT","GY","HT","HN","JM","MQ","MS","NI","PA","PY","PE","PR","KN"],"hiring_countries_total":50,"salary":null,"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false},{"name":"OpenAI","optional":false}],"status":"live","first_seen_at":"2026-11-09T18:51:03Z","employer_posted_date":"2026-11-09","last_verified_at":"2026-11-10T00:25:20Z","board_verified":true,"closed_at":null,"days_open":0,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":0},"description":"Work From Anywhere in LATAM or the Philippines\nWork Schedule: 9AM - 5PM PST\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 venture-backed virtual pediatric care company is looking for a Revenue Cycle Management Specialist to run day-to-day billing operations and keep insurance reimbursement and patient payments flowing on time.\nThe company delivers virtual, multi-specialty care for children with chronic conditions such as ADHD and anxiety, with referrals coming from pediatricians across multiple US states. It is in-network with major commercial insurers, serves both commercial and Medicaid families, and recently raised a Series A to expand into new care areas.\nAbout the Role\nThe RCM Specialist owns the revenue cycle from insurance verification and claims submission through payment posting, claims follow-up, denials, and patient collections, reporting to the Team Lead. The role works directly with patients, families, payers, and internal teams to resolve billing and reimbursement issues. Success means clean claims, faster reimbursement, fewer repeat denials, and a clear billing experience for families.\nCore Responsibilities\nEligibility & Benefits Verification\nVerify insurance eligibility and benefits before visits, before claim submission, and during follow-up.\nConfirm copays, deductibles, coinsurance, out-of-pocket maximums, and in-network status.\nInvestigate inactive policies, coverage limits, and discrepancies.\nDocument verification results accurately in designated systems.\nClaims Submission\nValidate demographics, insurance details, CPT and ICD-10 codes, modifiers, and place of service before submission.\nSubmit claims within payer timely filing requirements.\nMonitor clearinghouse and payer acknowledgments, and correct and resubmit rejected claims.\nRoute coding questions to the designated reviewer.\nPayment Posting\nPost insurance payments, adjustments, and denials from ERAs and EOBs.\nPost patient payments according to billing and collection procedures.\nReconcile posted payments against deposits and remittance totals.\nFlag underpayments and overpayments against expected reimbursement.\nClaims Follow-up, Denials & Appeals\nFollow up on unpaid, pending, and underpaid claims through payer portals.\nIdentify denial root causes and complete corrections, resubmissions, reconsiderations, and appeals.\nTrack denial trends and recovery outcomes, and flag recurring payer, coding, or eligibility issues.\nEscalate complex or unresolved claims to the Team Lead.\nPatient Billing & Collections\nExplain coverage, benefits, and expected costs to patients and families based on verified benefits.\nConduct outreach on outstanding copays, coinsurance, deductibles, and self-pay balances.\nSet up payment arrangements within approved guidelines.\nRespond to billing inquiries by phone, email, and patient portal.\nDocumentation & Quality\nDocument all RCM activity in designated systems following SOPs, payer guidelines, and HIPAA requirements.\nMeet assigned productivity, quality, and turnaround-time targets.\nRecommend workflow improvements based on recurring billing issues.\nRequirements\nMust-Have\n2+ years of hands-on US healthcare revenue cycle or medical billing experience\nHands-on experience across eligibility and benefits verification, claims submission, payment posting, claims follow-up, and denial management\nWorking knowledge of US commercial insurance and Medicaid, including copays, deductibles, coinsurance, and network status\nWorking knowledge of CPT, ICD-10, and modifiers for claim review and validation\nPayment posting from ERAs and EOBs, including adjustments, denials, and deposit reconciliation\nHands-on use of payer portals, clearinghouses, and billing platforms, with HIPAA-compliant handling of PHI\nEnglish at C1+ CEFR level for live patient, family, and payer calls\nNice-to-Have\nCPB or CRCR certification\nExperience with Medicaid managed care plans\nHands-on experience with a practice management or EHR system\nPediatric, behavioral health, or telehealth billing experience\nSpanish fluency for patient and family outreach\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. 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