Remote Pediatric RCM Specialist: Denials & Authorizations

Pearl; Philippines; Remote; PHP 446,000 - 670,000; Full time

Benefits offered by this job

Fully remote

Competitive salary

Paid time off (PTO)

Job summary

Pearl Talent is hiring a Revenue Cycle Specialist to own denials management and prior authorizations on the provider side. 70–80% of work happens in the Candid clearinghouse, with the rest on an internal authorization dashboard.

The role reports to the Head of RCM and aims to shrink the backlog of 1,000–2,500 items and improve A/R metrics. This fully remote position in the Philippines offers competitive salary, PTO, health coverage after probation, mentorship, and ongoing professional

Qualifications

• 2–5 years of provider-side healthcare revenue cycle experience at a practice, clinic, or outpatient provider (3+ years preferred).
• Hands-on denials management: appeals, corrections, and resubmissions.
• Hands-on prior authorization experience: submitting, tracking, and follow-up with payers.
• Experience with at least one clearinghouse or RCM platform (Candid Health, Waystar, Availity, Change Healthcare, Office Ally).
• Working knowledge of denial codes, NPI, payer IDs, and provider enrollment requirements.

Responsibilities

• Denials Management & Claims Resolution: work denial queues daily and resolve claims via appeal or correction.
• Prior Authorization Submission & Tracking: submit and track authorizations through dashboards.
• Reporting & Performance Monitoring: update KPI dashboards and flag denial trends.

Skills

Denials management

Prior authorizations

Clearinghouse experience

English (CEFR) C2

NPI/payer IDs

Tools

Candid Health

Waystar

Availity

Change Healthcare

Office Ally

Job description

Pearl Talent is hiring a Revenue Cycle Specialist to own denials management and prior authorizations on the provider side. 70–80% of work happens in the Candid clearinghouse, with the rest on an internal authorization dashboard.

The role reports to the Head of RCM and aims to shrink the backlog of 1,000–2,500 items and improve A/R metrics. This fully remote position in the Philippines offers competitive salary, PTO, health coverage after probation, mentorship, and ongoing professional