Remote Medical Revenue Cycle Specialist - Pediatric PDN

Peak Support; Philippines; Remote; PHP 600,000 - 900,000; Full time

Benefits offered by this job

Work from home

Remote-friendly culture

Job summary

Peak Support is seeking a Medical Revenue Cycle Specialist for the Philippines to manage insurance verification, authorizations, SCAs, and reauthorizations for Pediatric Private Duty Nursing (PDN). You will work closely with Sales, Clinical, Scheduling, Recruiting, Accounting, and Operations to ensure timely onboarding and compliant authorization records.

The role emphasizes processing, escalation when needed, and ensuring payer requirements are met before services begin, with a fully remote

Qualifications

• Experience in medical billing or healthcare administration with a focus on revenue cycle management.
• Familiarity with insurance eligibility checks, authorization requirements, and payer follow-up processes.
• Strong organizational and multi-case management skills.
• Excellent written and verbal communication with insurance carriers and internal teams.
• Detail-oriented for reviewing clinical documentation and authorizations.

Responsibilities

• Review new patient referrals and collect required demographics, insurance, and clinical information.
• Verify eligibility, coverage dates, and out-of-pocket responsibilities across primary/secondary plans.
• Submit complete authorization packets to UM departments and track references.
• Coordinate with Clinical to support nursing hours, frequency, and duration.
• Monitor and follow up on authorization requests and approvals.
• Manage reauthorization timelines and ensure updated authorizations before periods begin.
• Coordinate appeals and collect supporting clinical documentation as needed.
• Maintain patient setup in systems and ensure accurate authorization records.

Skills

Insurance verification

Authorization management

New case intake

Clinical coordination

Documentation accuracy

Tools

Availity

NJ Medicaid Portal

AlayaCare

HHAeX

Job description

Peak Support is seeking a Medical Revenue Cycle Specialist for the Philippines to manage insurance verification, authorizations, SCAs, and reauthorizations for Pediatric Private Duty Nursing (PDN). You will work closely with Sales, Clinical, Scheduling, Recruiting, Accounting, and Operations to ensure timely onboarding and compliant authorization records.

The role emphasizes processing, escalation when needed, and ensuring payer requirements are met before services begin, with a fully remote