The role
Neon Link places experienced US healthcare revenue cycle professionals with US medical practices, billing companies, behavioral health groups and DME suppliers, matched to whichever of four lanes you know best: billing and AR follow-up, medical coding, prior authorization and eligibility, or provider credentialing and payer enrollment. Billing and AR own the claim from submission through denial, appeal and payment, in the client's practice management system, such as Kareo or Tebra, AdvancedMD or athenahealth, and on payer portals like Availity.
Coders assign CPT, ICD-10-CM and HCPCS codes from the provider's documentation and hold the line when a payer pushes back. Prior authorization and eligibility clear the way before the visit, and credentialing keeps providers enrolled and in network through CAQH ProView, PECOS and payer enrollment, so the claims can be paid at all. Coding is mostly screen work; the other lanes spend much of the shift on calls and portals with US payers.
It matters because a practice runs on money it has already earned: a denial nobody works, a code the note won't support or an enrollment that lapses is money that never arrives.
Every placement handles patient health information under HIPAA rules and a signed BAA, the business associate agreement US healthcare privacy law requires, so we look for people who are careful by habit, not only when someone is watching. People do well here when they read a denial and know the next move, document every call, and keep the provider informed without being chased. Day to day you'll take direction from the client's practice manager, billing lead or credentialing lead, as part of their team, with Neon Link behind you. Before your first live claim, chart or enrollment you're trained on the client's systems, payer rules and escalation path.
What you'll do
- Billing and AR: review charges and submit clean claims on the CMS-1500 or UB-04 with the right modifiers and payer rules, and clear clearinghouse rejections and front end edits before they reach the payer
- Billing and AR: work the aging report by bucket, oldest and largest balances first, check claim status by payer portal, IVR or phone, and correct, resubmit or appeal each denial from its CARC and RARC codes until it's paid or closed for a documented reason
- Billing and AR: post payments from ERAs and EOBs, spot underpayments against the fee schedule or payer contract, and flag credit balances and overpayments for refund review
- Coding: assign CPT, ICD-10-CM, HCPCS Level II and modifiers from the provider's documentation under E/M guidelines, NCCI edits and LCD and NCD rules, query the provider when a note won't support the code, recode or defend coding denials from the record, and keep up with annual code set changes
- Prior authorization and eligibility: verify eligibility and benefits before the visit, submit authorizations through payer portals with the clinical notes the payer's criteria call for, and track each one to approval, peer to peer review or appeal
- Credentialing: build and maintain CAQH ProView profiles and attestations, file CMS-855 applications through PECOS, keep NPPES current, run commercial and Medicaid payer enrollments, revalidations and re-credentialing, and track every expirable, including licenses, DEA registrations, board certification and malpractice coverage
- Log every payer call, portal check and provider query in the client's system with a reference number, name, date and next step, so anyone on the team can pick up the account
- Escalate payer problems with the facts already gathered: claim or application number, call reference, timeline and what you tried, and send the provider or practice manager a short weekly note on what moved, what's stuck and what you need
- For billing and AR, clean claim rate, first pass denials, days in AR and the 90 plus day bucket moving the right way, against targets set with the client
- For coding, accuracy on the client's coding audits, and few denials that trace back to a code you assigned
- For prior authorization and eligibility, every scheduled visit verified and every required authorization on file before the date of service, on the client's timelines
- For credentialing, CAQH attestations and every expirable tracked for every provider, and enrollments submitted complete so they don't come back for missing items
What you bring
- 2 or more years in one of the four lanes, on the provider side for US practices, billing companies or RCM companies; tell us which lane, for how long, and which is strongest if you've worked more than one
- Billing for Philippine hospitals, clinics or PhilHealth claims doesn't count for this role, and neither does US healthcare work limited to scheduling, payer-side claims processing, or a coding course without production coding on US charts
- Billing and AR: hands-on denial, appeal and aging AR work by phone and payer portal, fluent in CARC and RARC codes, CMS-1500 and UB-04 claims, modifiers and timely filing, in at least one US practice management or EHR system, for example Kareo or Tebra, AdvancedMD, eClinicalWorks, athenahealth, DrChrono, NextGen or Epic, and a clearinghouse such as Availity, Office Ally or Waystar, with the patience to stay professional at minute forty on hold
- Coding: production coding on live US charts in CPT, ICD-10-CM, HCPCS Level II and modifiers under E/M guidelines, NCCI edits and LCDs, with an EHR and an encoder such as EncoderPro or Find-A-Code, and a current CPC, COC or CCS; tell us your specialty, such as E/M, emergency department, surgery, radiology or risk adjustment
- Prior authorization and eligibility: eligibility and benefits checks for US patients through payer portals and calls, and authorizations submitted with medical necessity documentation and tracked to a decision, including peer to peer requests and appeals
- Credentialing: CAQH ProView profiles and attestations, Medicare enrollment through PECOS and the CMS-855 forms, NPPES updates, and commercial and Medicaid payer enrollment and re-credentialing for individual providers and groups
- Every lane: working knowledge of how commercial plans, Medicare, Medicare Advantage, Medicaid and workers comp differ on coverage rules, appeals and timely filing
- Careful with patient and provider information: you understand the HIPAA minimum necessary rule and don't move charts, EOBs, patient lists or provider files onto personal devices, and you'll sign a confidentiality agreement and pass a background check, including a current NBI clearance
- Clear spoken English for calls with US payer reps and providers, and clear written English for appeals, provider queries and account notes
- Able to work US business hours, a night shift that starts between 8pm and 1am Philippine time depending on the client's US time zone and the time of year, and to hold that schedule long term
- Education: any bachelor's degree preferred, not required; relevant experience matters more
- Outside the coding lane, a current CPB, CRCR, CPCS or CPMSM; for coders, a second credential such as CPMA
- A specialty you know cold, for example behavioral health, orthopedics, DME, anesthesia, oncology or telehealth
- Credentialing platforms such as Modio, Verifiable, CredentialStream or symplr
- Experience working alongside billing or coding automation, clearing the claims and charts it flags
- Excel or Google Sheets past the basics, including pivot tables, lookups and a readable AR aging report
Work setup
- Your own Windows 10 or 11 computer with a Core i5 or Ryzen 5 and 8 GB of RAM or more that runs the client's tools, plus two monitors, a webcam and a noise canceling headset
- Fiber internet of at least 25 Mbps with a mobile data or second provider backup
- A UPS or generator so a brownout doesn't end your shift
- A quiet, private workspace where patient information can't be seen or overheard
- Tell us your city and province when you apply; we hire across regions, so one storm or outage doesn't hit everyone at once
You'll do well here if
Questions applicants ask
- Is this job work from home?
- Yes. Remote, work from home, anywhere in the Philippines, no night commute.
- How much does it pay?
- PHP 45,000 to 60,000 a month (about PHP 268 to 357 an hour). About USD 715 to 955 a month at today's exchange rate. The rate already covers night hours. Pay is in Philippine pesos (PHP).
- What are the working hours?
- Monday to Friday, US business hours (night shift in the Philippines), weekends off; exact shift set with the client.
- When would I start?
- Hiring now.
- How do I apply?
- Use the form on this page: your resume, a few questions about this role, your expected pay and a short voice introduction you record on the page. A person reads every application.
- Does Neon Link charge a fee to apply?
- No. Neon Link never charges a fee to apply, test, train or start, and only contacts applicants from neonlink.ai email addresses.