Remote Pediatric RCM Specialist — Healthcare Billing Expert

Pearl; Philippines; Remote; MXN 1,211,000 - 1,583,000; Full time

Benefits offered by this job

Remote work: fully remote

Global team exposure

Growth opportunities

Job summary

Pearl Talent is hiring a Revenue Cycle Management Specialist for a venture-backed virtual pediatric care company. The role runs day-to-day billing operations to keep insurance reimbursement and patient payments flowing on time.

This remote position supports eligibility verification, claims submission, payment posting, denials management, and patient collections for US commercial insurers and Medicaid, with a 9am-5pm PST schedule.

Qualifications

• 2+ years of US healthcare revenue cycle experience.
• Experience with eligibility and benefits verification, claims submission, payment posting, and denial management.
• Knowledge of CPT, ICD-10, and modifiers; PHI handling per HIPAA.
• Experience with payer portals and clearinghouses; HIPAA-compliant data handling.
• English CEFR level C1+ for live patient, family, and payer calls.

Responsibilities

• Verify insurance eligibility and benefits before visits and during follow-up.
• Submit claims within payer filing timelines and correct resubmissions.
• Post insurance and patient payments; reconcile and flag discrepancies.
• Follow up on unpaid or underpaid claims; manage denials and appeals.
• Explain coverage and billing to families; set up payment plans.
• Document all RCM activity following SOPs and HIPAA.

Skills

Revenue cycle

Eligibility verification

Claims submission

Payment posting

Denials management

HIPAA compliance

Payer portals

PHI handling

English C1+

Tools

Practice management system

Billing software

Clearinghouse software

Job description

Pearl Talent is hiring a Revenue Cycle Management Specialist for a venture-backed virtual pediatric care company. The role runs day-to-day billing operations to keep insurance reimbursement and patient payments flowing on time.

This remote position supports eligibility verification, claims submission, payment posting, denials management, and patient collections for US commercial insurers and Medicaid, with a 9am-5pm PST schedule.