Verify insurance eligibility and benefits before visits, claim submission, and follow-up; investigate coverage issues and document results.
Validate demographics, insurance details, CPT and ICD-10 codes, modifiers, and place of service before submitting claims.
Submit claims within payer filing requirements, monitor acknowledgments, and correct and resubmit rejected claims.
Post insurance and patient payments, adjustments, and denials from ERAs and EOBs; reconcile payments against deposits and remittance totals.
Follow up on unpaid, pending, and underpaid claims through payer portals; complete corrections, reconsiderations, and appeals.
Track denial trends and recovery outcomes, flag recurring issues, and escalate complex claims to the Team Lead.
Explain coverage, benefits, and expected costs to patients and families; conduct outreach on outstanding balances and arrange payments within guidelines.
Respond to billing inquiries by phone, email, and patient portal.
Document RCM activity according to SOPs, payer guidelines, and HIPAA requirements; meet productivity, quality, and turnaround targets.
Recommend workflow improvements based on recurring billing issues.
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About Pearl Talent
Pearl Talent empowers global talent by connecting them with leading US and EU startups, leveling the playing field for ambitious professionals worldwide. We bridge opportunity gaps, pairing the top 1% of talent from emerging markets like the Philippines and Latin America with companies backed by top-tier investors like Y Combinator and a16z. Our clients have collectively raised over $5 billion, driving innovation in diverse sectors. We offer both managed services and direct placement, enabling businesses to scale efficiently and individuals to build long-term, impactful careers.
How We Work
Pearl Talent is a fully remote-first company, emphasizing flexibility and global collaboration. We cultivate a culture of growth, challenging team members to take ownership and make a tangible impact. Decision-making prioritizes clear communication and collective problem-solving. We embrace AI tools to enhance workflows and efficiency, fostering a forward-thinking environment where continuous learning is key.
Why Join Us
Connect with visionary US and EU founders, building long-term, impactful careers.
Grow professionally with direct mentorship from international industry experts and continuous learning resources.
Work in a fully remote environment with flexible schedules and unlimited PTO for internal roles.
Contribute to a mission that levels global opportunity, placing top talent with high-growth startups.
Collaborate with a diverse, international team and engage in global networking.
Benefits & Perks
Competitive salary based on experience and skills.
Fully remote work – work from anywhere.
Generous PTO in accordance with company policy.
Direct mentorship from international industry experts.
Ongoing access to resources for professional growth.
Global networking opportunities.
Health coverage (HMO) after 3 months for full-time employees in the Philippines.