Insurance Billing Specialist (US Healthcare Company)

Work Arrangement: Fully remote, overlapping CST working hours

Job Type: Full-time

Work Schedule: 40 hours per week, Monday to Friday, 9:00AM - 5:00PM CST

Locations: Remote, open only to candidates based in the Philippines

About Pearl Talent:

Pearl 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. They’re looking for the sharpest, hungriest candidates who they can consistently promote and work with over many years. Candidates we’ve hired have been flown out to the US and EU to work with their clients, and even promoted to roles that match folks onshore in the US.

Why Work with Us?

We mean what we say that we’re building a different recruiting company here. We only work with exceptional founders from the US and EU who care about the long-term success of their team members. We also provide you with attainable 3, 6, 9, 12 month, and beyond retention bonuses in addition to community oriented opportunities like an annual retreat.

About the Company:

The company is a leading organization specializing in innovative fertility solutions, providing tailored products and services to empower individuals and families on their journey to parenthood. Guided by a mission to revolutionize fertility care through cutting-edge science and empathetic support, the company operates as a dynamic, fast-paced organization at the forefront of its industry. Its team prioritizes collaboration, efficiency, and a steadfast commitment to excellence, delivering exceptional experiences to clients and stakeholders alike.

Role Overview:

The Insurance Billing Specialist will ensure efficient revenue cycle processes, including insurance verification, prior authorizations, credentialing, billing, and communication with clients and payers. This role will focus on accuracy, compliance, timely billing, and client satisfaction for ABA practices, requiring strong communication, problem-solving skills, and a proactive approach.

Key Responsibilities:

1. Revenue Cycle Management

• Prepare, submit, and audit insurance claims to ensure accuracy and compliance.
• Investigate and appeal denied claims, troubleshoot payment delays, and resolve billing issues.
• Manage patient accounts, post payments, and assist with payment plans while generating reports on billing activity and collections.

2. Insurance Verification & Credentialing

• Verify insurance benefits, secure pre-authorizations, and manage reimbursement requirements.
• Handle provider contracting and credentialing, including managing applications, payor updates, and rate negotiations.
• Collaborate with providers to gather documentation and resolve authorization or credentialing issues.

3. Compliance & Client Communication

• Ensure HIPAA compliance and maintain organized, accurate billing records.
• Serve as the primary contact for client inquiries, provide updates, and address account receivable concerns through proactive communication.
• Stay updated on industry trends and identify opportunities to improve processes and workflows.

• Experience & Expertise: Minimum of 3yrs in billing, preferably in healthcare or ABA therapy, with proven experience in revenue cycle management, insurance credentialing, and billing processes.
• Technical Skills: Proficient in payer portals, electronic health records, and billing software like CentralReach; knowledgeable about CPT codes and payer-specific requirements.
• Key Competencies: Excellent written and verbal communication, problem-solving, and organizational skills; ability to multitask, manage time effectively, and maintain data integrity.
• Teamwork & Independence: Works well with teams, demonstrates strong interpersonal skills for client and provider collaboration, and can work independently to meet deadlines.

Compensation Package:

• Remote Work: Fully remote—work from anywhere
• Work Schedule: Monday to Friday, 9:00am - 5:30pm CST with a 30-minute lunch break
• Generous PTO: Ample paid time off to rest and recharge
• Health Coverage: HMO coverage after 3 months for full-time employees
• Direct Mentorship: Grow through guidance from international industry experts
• Learning & Development: Ongoing access to resources for professional growth
• Global Networking: Work and connect with professionals around the world
• Work-Life Balance: Flexible hours that support a healthy work-life balance

Our Recruitment Process:

1. Application
2. Screening
3. Skills Assessment
4. Top-grading interview
5. Client Interview
6. Job Offer
7. Client Onboarding

Ready to Join Us?

If this role aligns with your skills and career goals, we’d love to hear from you. Apply now to take the next step in your journey with Pearl.