Remote Medical Billing Specialist – Claims & Compliance

All Care To You; Orange (CA); Remote; USD 52,000 - 78,000; Full time

Benefits offered by this job

Health insurance

Paid holidays

Paid time off

401k plan

Job summary

All Care To You is seeking a Medical Billing Coordinator to manage outstanding claims, liaise with insurers and providers, and ensure timely reimbursement. The role requires strong problem-solving skills, attention to detail, and the ability to work across multiple systems ensuring compliance with industry standards.

In this fully remote, California-based position, you will be essential to maintaining client satisfaction and financial health for our physician association clients.

Qualifications

• Minimum 3 years’ experience as a medical biller or similar role.
• Strong technical skills and ability to learn multiple systems quickly.
• Experience with EZ-Cap and EDI Clearinghouse tools is preferred.
• Proficiency with Microsoft Suite (Outlook, Teams, Office365, OneNote, OneDrive, SharePoint).
• Knowledge of CPT/ICD-10, modifiers, MUE, LCD/NCD and CCI edits.
• Excellent written and verbal communication skills.

Responsibilities

• Conduct timely and accurate follow-up on professional services claims to ensure information is complete and claims are processed via payor portals, chat, messaging, and calls.
• Identify missing payments from health plans and initiate tracking procedures.
• Review incoming correspondence from health plans and take appropriate action or escalate as needed.
• Identify pending claims and determine next steps to obtain reimbursement.
• Review denials for processing errors and resubmit corrected claims as needed.
• Follow up with carriers, providers, or stakeholders to gather information required for resolution.
• Monitor messages from providers and respond or escalate as needed.
• Escalate complex issues to the appropriate team member for resolution.
• Research health plan policies, coding guidelines, and CCI edits to ensure proper billing.
• Maintain documentation of claim status, actions, and resolutions.

Skills

Medical billing

Time management

Multitasking

Communication

Attention to detail

Tools

EZ-Cap

EDI Clearinghouse (Office Ally)

Microsoft Office 365

SQL Server Management Studio

Confluence

Azure

Job description

All Care To You is seeking a Medical Billing Coordinator to manage outstanding claims, liaise with insurers and providers, and ensure timely reimbursement. The role requires strong problem-solving skills, attention to detail, and the ability to work across multiple systems ensuring compliance with industry standards.

In this fully remote, California-based position, you will be essential to maintaining client satisfaction and financial health for our physician association clients.