Industry
Healthcare / Revenue Cycle Management / Behavioral Health
Work Arrangement
Remote
Job Type
Full-Time
Work Schedule
US Business Hours
Locations
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.
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Why Work with Us?
At Pearl, we’re not just another recruiting firm—we connect you with exceptional opportunities to work alongside visionary US and EU founders. Our focus is on placing you in roles where you can grow, be challenged, and build long-term, meaningful careers.
About the Company
Our client is a growing healthcare services organization focused on optimizing revenue cycle operations within the behavioral health space. The company is committed to building efficient, scalable billing systems that improve claim accuracy, reduce preventable delays, and maximize reimbursement outcomes. They operate in a fast-paced environment where operational excellence, accountability, and proactive communication are highly valued.
Role Overview
The Billing Specialist serves as the first line of defense in the revenue cycle by ensuring claims are clean, accurate, and ready for timely submission. This role is highly execution-focused and requires strong attention to detail across pre-submission workflows, coding accuracy, and billing queue management. The ideal candidate will proactively resolve claim issues before submission, collaborate cross-functionally with clinical and administrative teams, and maintain high billing throughput with minimal preventable holds. This role is well-suited for someone who thrives in process-driven environments and takes ownership of operational performance metrics.
Your Impact
In this role, you will directly contribute to improving billing efficiency and reducing preventable claim delays across the revenue cycle. Your work will support timely claim submission, stronger cash flow performance, and improved billing accuracy. By proactively resolving coding and EHR-related billing issues, you will help reduce denial risk and improve operational visibility across teams. You will also play a key role in maintaining clean billing queues and ensuring eligible claims move through the system without unnecessary interruptions.
Core Responsibilities
Coding & Pre-Submission Accuracy – 40%
- Review and resolve coding issues flagged in billing systems prior to claim submission.
- Identify and correct missing information, demographic mismatches, and coding inconsistencies.
- Ensure claims are submitted accurately and within payer timelines.
- Validate CPT, ICD-10, and modifier usage to support billing compliance.
EHR Billing Queue Management – 30%
- Monitor and resolve billing issues held within the EHR system.
- Coordinate with clinical and administrative teams to obtain missing documentation.
- Maintain clean billing queues by proactively addressing preventable claim holds.
- Escalate recurring workflow issues impacting claim submission efficiency.
Secondary Insurance Billing – 20%
- Process claims requiring secondary insurance billing and coordination of benefits.
- Attach primary EOB documentation where required.
- Follow up on secondary claims through resolution.
- Ensure accurate payer sequencing and claim routing.
Reporting & Billing Performance – 10%
- Track billing percentage metrics and identify trends impacting claim holds.
- Support operational reporting related to pre-submission performance.
- Recommend process improvements to reduce preventable delays.
- Maintain accurate documentation and billing activity records.
Requirements
Must-Haves (Required)
- Minimum 1 year of experience in medical billing or revenue cycle management.
- Strong understanding of pre-submission workflows and claim editing processes.
- Experience working within an EHR platform.
- Knowledge of CPT, ICD-10, and modifier usage.
- Strong organizational skills and high attention to detail.
- Excellent written and verbal English communication skills.
- Ability to manage multiple priorities in a fast-paced environment.
Nice-to-Haves (Preferred)
- Experience in ABA or behavioral health billing.
- Familiarity with secondary billing and coordination of benefits processes.
- Experience working with TRICARE, HMSA, Medicaid, and commercial insurers.
- Exposure to high-volume healthcare billing operations.
Tools Proficiency
Must-Haves (Required)
- Candid or similar billing platforms
- EHR systems
- Google Workspace
- Microsoft Excel or Google Sheets
- Payer portals
Nice-to-Haves (Preferred)
- Reporting and analytics tools
- Workflow management tools
- Internal healthcare communication systems
Benefits
- Competitive Salary: Based on experience and skills
- Remote Work: Fully remote—work from anywhere
- Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting
- Generous PTO: In accordance with company policy
- Health Coverage for PH-based talents: HMO coverage after 3 months for full-time employees
- Direct Mentorship: Guidance from international industry experts
- Learning & Development: Ongoing access to resources for professional growth
- Global Networking: Connect with professionals worldwide
Our Recruitment Process
- Application
- Screening
- Skills Assessment
- Top-grading Interview
- Client Interview
- Job Offer
- Client Onboarding
Ready to Join Us?
If this role aligns with your skills and goals, apply now to take the next step in your journey with Pearl.
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