Remote Medical Billing & Coding Specialist - Claims Expert

AAPC; Turlock (CA); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Remote work option

Job summary

AAPC is seeking a detail-oriented Medical Billing Specialist in California to manage claims submission, coding, and cost estimates. The role involves working with patients and payers to ensure timely reimbursement within EHR/EMR workflows.

The candidate should have CPC/CCS credentials and 2+ years in medical billing, coding, and insurance follow-up, with proficiency in Epic/Meditech/PrognoCis and HIPAA compliance. Remote work possible based on experience.

Qualifications

• Minimum 2 years of experience in medical billing, coding, insurance follow-up, and EHR/EMR systems.
• Familiarity with ICD-10, CPT, and HCPCS coding systems.
• Experience creating cost estimates for procedures and submitting appeals.
• Strong knowledge of payer reimbursement guidelines and HIPAA/compliance.

Responsibilities

• Accurately process and submit medical claims to insurance companies and government payers.
• Perform medical coding using ICD-10, CPT, and HCPCS standards.
• Generate and communicate cost estimates for procedures based on coverage.
• Review and verify billing data in EHR/EMR before submission.
• Utilize Epic, Meditech and PrognoCis for documentation and billing workflows.
• Research and resolve billing discrepancies or claim denials.
• Prepare and submit insurance appeals per payer guidelines.
• Communicate with patients about billing questions and coverage.
• Keep up-to-date with medical terminology, payer requirements, and HIPAA/CMS regulations.
• Collaborate with clinical staff to ensure accurate coding and documentation.
• Track accounts receivable and follow up on outstanding claims.

Skills

Medical billing

Medical coding

Insurance follow-up

Communication

EHR/EMR proficiency

Education

Associate's degree in Healthcare Administration/Billing & Coding

High school diploma or equivalent

Tools

Epic

Meditech

PrognoCis

Job description

AAPC is seeking a detail-oriented Medical Billing Specialist in California to manage claims submission, coding, and cost estimates. The role involves working with patients and payers to ensure timely reimbursement within EHR/EMR workflows.

The candidate should have CPC/CCS credentials and 2+ years in medical billing, coding, and insurance follow-up, with proficiency in Epic/Meditech/PrognoCis and HIPAA compliance. Remote work possible based on experience.