Note: The job is a remote job and is open to candidates in USA. Zócalo Health is a tech-driven healthcare provider focused on serving the Latino community. The Medical Billing Specialist (CPC) will support accurate and compliant billing across various healthcare services while collaborating with the Revenue Cycle Management team to enhance reimbursement processes and resolve claim issues.
Responsibilities
• Provide accurate and compliant coding and billing for Primary Care, Urgent Care, and Behavioral Health services across Medi-Cal managed care plans and Medi-Cal initiatives, including ECM, CHW, and Care Services
• Ensure claims are reviewed, coded correctly, submitted timely, and followed through to resolution in alignment with payer, regulatory, and internal requirements
• Actively research and resolve claim denials and rejections to improve reimbursement outcomes and first-pass claim acceptance
• Partner with Revenue Cycle team members to identify trends impacting claims performance and support continuous process improvement
• Maintain accurate documentation and billing records within Athena and related billing systems to support audit readiness and compliance
• Provide additional billing and revenue cycle support as needed to support team priorities and ensure continuity of Revenue Cycle operations
Skills
• High school diploma or equivalent required
• Active Certified Professional Coder (CPC) or CPC-A certification required
• 3 to 5 years of medical billing experience
• Experience billing Medi-Cal managed care plans in California
• Strong understanding of revenue cycle workflows, including claim review, coding accuracy, submission, denial management, appeals, and follow-up
• Ability to maintain accuracy, confidentiality, and compliance with HIPAA requirements in a remote work environment
• Strong written and verbal communication skills
• Demonstrated experience coding and billing for Primary Care, Urgent Care, and Behavioral Health services
• Direct experience billing Medi-Cal initiatives, including Enhanced Care Management (ECM), Community Health Worker (CHW), and Care Services (CS)
• Experience working with electronic health record and practice management systems, including Athena
• Experience using revenue cycle management platforms and clearinghouse tools, such as Candid
• Strong analytical skills with the ability to identify trends related to denials, underpayments, and payer behavior
Benefits
• Equity compensation package
• Comprehensive benefits including medical, dental, and vision
• 401k
• Generous PTO policy (up to 15 days per year for FT employees)
• $1,000 home office stipend
• We provide the equipment needed for this role.
• Opportunity for rapid career progression with plenty of room for personal growth.
Company Overview
• Now serving patients in California, Texas, Washington, and Maryland (July 2025)! Introducing Zócalo Health, a primary care and care management service specializing in culturally-sensitive care for the Latino community. It was founded in 2021, and is headquartered in Seattle, Washington, US, with a workforce of 51-200 employees. Its website is https://www.zocalo.health/.