Remote US Healthcare RCM Specialist

Pearl; Central Luzon; Remote; PHP 3,781,000 - 5,671,000; Full time

Benefits offered by this job

Remote work

Generous PTO

Health coverage for PH-based talents

Direct mentorship

Learning & Development

Global networking

Job summary

Pearl Talent is recruiting a Revenue Cycle Management Specialist to run day-to-day billing operations for a venture-backed pediatric care client. This fully remote role handles eligibility, submissions, denials, and patient collections, interfacing with payers and families across multiple US states.

You will ensure clean claims and timely reimbursement while maintaining HIPAA-compliant practices. The position offers remote work from anywhere, competitive salary, and opportunities for mentorship

Qualifications

• 2+ years of hands-on US healthcare revenue cycle or medical billing experience
• Experience across eligibility and benefits verification, claims submission, payment posting, claims follow-up, and denial management
• Working knowledge of US commercial insurance and Medicaid, including copays, deductibles, coinsurance, and network status
• Knowledge of CPT, ICD-10, and modifiers for claim review and validation
• Payment posting from ERAs and EOBs, including adjustments, denials, and deposit reconciliation
• HIPAA-compliant handling of PHI using payer portals, clearinghouses, and billing platforms
• English at C1+ CEFR level for live patient, family, and payer calls

Responsibilities

• Verify insurance eligibility and benefits before visits, before claim submission, and during follow-up
• Submit claims within payer timely filing requirements
• Monitor clearinghouse and payer acknowledgments, and correct and resubmit rejected claims
• Post insurance payments, adjustments, and denials from ERAs and EOBs
• Post patient payments and reconcile with deposits and remittance totals
• Follow up on unpaid, pending, and underpaid claims through payer portals
• Identify denial root causes and complete corrections, resubmissions, reconsiderations, and appeals
• Explain coverage and costs to patients and families based on verified benefits
• Document all RCM activity in designated systems following SOPs and HIPAA
• Meet productivity, quality, and turnaround-time targets
• Suggest workflow improvements based on recurring issues

Skills

US healthcare revenue cycle

Medical billing

CPT/ICD-10 knowledge

HIPAA compliance

PHI handling

English proficiency

Tools

Payer portals

Clearinghouses

Billing platforms

Job description

Pearl Talent is recruiting a Revenue Cycle Management Specialist to run day-to-day billing operations for a venture-backed pediatric care client. This fully remote role handles eligibility, submissions, denials, and patient collections, interfacing with payers and families across multiple US states.

You will ensure clean claims and timely reimbursement while maintaining HIPAA-compliant practices. The position offers remote work from anywhere, competitive salary, and opportunities for mentorship