Work Arrangement: Fully Remote
Job Type: Independent Contractor, Full-time
Work Schedule: Monday to Friday | 9:00 AM – 5:00 PM EST
Locations:
- LATAM: Mexico City (Mexico), Bogotá (Colombia), São Paulo (Brazil), Buenos Aires (Argentina)
- Philippines: Manila, Cebu, Davao — with reliable MST overlap
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.
Hear why we exist, what we believe in, and who we’re building for: WATCH HERE
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.
Role Overview
Our client is seeking a Medical Billing Team Lead to oversee end-to-end billing operations while managing a team of billing specialists. This role is responsible for ensuring accurate claims processing, timely reimbursements, and compliance with payer requirements. You will act as the subject matter expert for billing processes while guiding team members and resolving complex issues. The role requires strong attention to detail, leadership capability, and hands-on experience across the full medical billing lifecycle. This is a highly execution-focused role with leadership responsibilities in a fast-paced healthcare environment.
Your Impact:
You will play a critical role in maintaining a smooth and efficient billing operation that supports uninterrupted patient care. Your leadership will improve team performance, reduce claim errors, and accelerate reimbursement cycles. By resolving complex billing issues and ensuring accurate patient cost estimates, you will enhance both provider efficiency and patient satisfaction. Your process improvements will contribute to operational scalability and long-term financial health of the organization.
Core Responsibilities
Team Leadership & Oversight – 30%
- Lead, coach, and mentor a team of medical billing specialists.
- Review team outputs to ensure accuracy and compliance with billing policies.
- Act as escalation point for complex payer and patient billing issues.
- Identify inefficiencies and implement process improvements and best practices.
Insurance Verification & Patient Cost Estimates – 25%
- Verify insurance eligibility and benefits through payer portals and systems.
- Communicate with insurance providers to confirm coverage details.
- Generate and explain accurate patient cost estimates for services.
- Confirm network participation and coordinate with credentialing as needed.
Billing & Claims Processing – 25%
- Enter, reconcile, and manage patient charges across systems.
- Process copays, co-insurance, and upfront payments accurately.
- Resolve claim submission errors and address payer denials.
- Conduct denial analysis, correct issues, and resubmit claims.
- Coordinate with clearinghouse and coding teams and process write-offs per policy.
Authorizations & Referral Management – 15%
- Submit and track prior authorizations and referrals.
- Monitor authorization limits, expirations, and utilization.
- Communicate authorization updates to providers and staff.
- Follow up on pending or resubmitted authorization requests.
Documentation Validation & Patient Communications – 5%
- Ensure timely and compliant submission of provider documentation.
- Respond to patient billing inquiries via email or ticketing systems.
- Maintain clear, empathetic, and policy-aligned communication.
Requirements
Must-Haves:
- 5+ years of experience in medical billing, including end-to-end billing workflows
- 1–2+ years of experience leading or mentoring a billing team
- Strong knowledge of insurance verification, claims processing, and denial management
- Experience handling payer communications and complex billing escalations
- Excellent written and verbal English communication skills
- High attention to detail and accuracy in financial and billing processes
- Ability to work in a fast-paced, high-volume environment
Nice-to-Haves:
- Experience in a multi-provider or clinic setting
- Familiarity with US healthcare billing standards and compliance
- Experience working with remote or distributed teams
- Background in process improvement or workflow optimization
Tools Proficiency
Required:
- Availity (insurance verification)
- EMRs (ability to learn and manage multiple systems)
- Payer portals and claims submission platforms
- Email and ticket-based communication systems
Preferred:
- Candid or similar billing systems
- Clearinghouse claim management platforms
Benefits
- Competitive Salary: Based on experience and skills
- Remote Work: Fully remote—work from anywhere
- Performance Bonus: Based on data accuracy, reporting timeliness, and overall sales efficiency
- 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.
