Billing Specialist

Catena

. Work denial queues daily in Candid and resolve claims through appeal or correction .

Posted 11/4/2026full-timeRemote • PhilippinesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare revenue cycle management, particularly in claims denial resolution and prior authorization processes. Proficient in analyzing denial patterns and implementing corrective actions to enhance operational efficiency.

Highest-signal resume keywords

Denials Management ExperiencePrior Authorization ExperienceHealthcare Revenue Cycle ExperienceCandid Health ExperienceCPT Coding Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ResolutionAppeals DraftingClaim Data CorrectionDenial Code KnowledgeNPI SetupPayer ID ManagementKPI Dashboard UpdatesEOB ReadingMedicaid BillingProvider Enrollment

Soft Skills

Communication SkillsProblem-SolvingTeam Leadership

Tools & Technologies

Candid HealthWaystarAvailityChange HealthcareOffice Ally

Industry Keywords

Healthcare Revenue CyclePediatric Therapy BillingAuthorization Queue ManagementClaim Turnaround TimeClean Claim Rate

About the role

Key responsibilities & impact

Work denial queues daily in Candid and resolve claims through appeal or correction
Draft and submit appeals for denied claims and track them to resolution
Fix pre-submission blockers such as incorrect NPI setup, missing payer IDs, and provider enrollment gaps
Correct claim data and resubmit claims to improve the clean claim rate
Identify root causes of recurring denials and implement preventive fixes
Submit prior authorizations through the internal authorization dashboard, primarily for Medicaid plans
Track authorization status and follow up with payers until requests are approved or denied
Share authorization decisions with providers and the scheduling team
Contact patients or families when authorizations require additional details or documents
Update KPI dashboards for days in A/R, claim turnaround time, and clean claim rate
Send regular updates on backlog status and denial trends
Identify denial and authorization patterns and recommend process or system changes
Report to the Head of RCM and work with little day-to-day oversight
Reduce the current backlog of 1,000–2,500 items and improve A/R days, claim turnaround time, and clean claim rate

Requirements

What you’ll need

2–5 years of provider-side healthcare revenue cycle experience at a practice, clinic, or outpatient provider; 3+ years preferred
Hands-on denials management experience, including working denial queues, drafting appeals, and resubmitting corrected claims
Hands-on prior authorization experience, including submitting requests, tracking status, and following up with payers
Experience with at least one clearinghouse or RCM platform, such as Candid Health, Waystar, Availity, Change Healthcare, Office Ally, or similar
Working knowledge of denial codes, NPI, payer IDs, and provider enrollment requirements
Prior ownership of a denial or authorization queue with measurable results
C2 English (CEFR) for phone calls with patients, families, and insurance payers
Medicaid billing and prior authorization experience preferred
Pediatric therapy billing experience preferred
CPT coding and EOB/ERA reading experience preferred
Team lead, supervisor, or trainer experience on a billing or RCM team preferred
Startup or high-growth healthcare practice experience preferred

Benefits

Comp & perks

Competitive Salary: Based on experience and skills
Fully remote work from anywhere in the Philippines
Team incentives and recognition for maintaining 100% CRM hygiene and on-time reporting
Generous PTO in accordance with company policy
HMO coverage after 3 months for full-time employees based in the Philippines
Direct mentorship from international industry experts
Ongoing access to learning and development resources
Global networking opportunities