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Insurance Coder Remote Jobs in California (NOW HIRING)

BetterHelp

Psychiatrist - (Remote)

Los Angeles, CA · Remote

$177 - $242/hr

At the same time, only 30% of therapists accept insurance. UpLift acts as the bridge between ... and hourly equivalent CPT codes. * Expand access to care: Provide psychiatric services to ...

PACS

Remote Biller

Fresno, CA · On-site +1

$35 - $36/hr

Remote Biller - Skilled Nursing Facility (SNF) Location: Fresno, CA (Remote Position) Full-Time Pay ... with insurance companies and resolve billing discrepancies • Assist with month-end close and ...

MCI

Remote Call Center Representative

Sacramento, CA · Remote

$17 - $21.75/hr

Disability Insurance: Short- and long-term disability coverage is available to help protect you ... Casual Dress Code: Be comfortable while you work. Compensation & Benefits That Fit Your Life MCI ...

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Insurance Coder Remote information

What are the key skills and qualifications needed to thrive as a Remote Insurance Coder, and why are they important?

To thrive as a Remote Insurance Coder, you need a thorough understanding of medical terminology, ICD-10, CPT, and HCPCS coding systems, usually backed by a relevant certification such as CPC or CCS. Familiarity with electronic health record (EHR) systems, coding software, and claim submission platforms is essential. Attention to detail, strong organizational skills, and the ability to work independently are vital soft skills in this remote role. These skills ensure accurate coding, timely billing, and compliance with healthcare regulations, which directly impact reimbursement and minimize claim denials.

What are some common challenges faced by remote insurance coders, and how can they be effectively managed?

Remote insurance coders often face challenges such as staying updated with frequent coding guideline changes, maintaining productivity without in-person supervision, and ensuring secure handling of sensitive patient data from home. To manage these, it's important to regularly participate in virtual training sessions, use secure VPN connections for accessing healthcare systems, and set a structured daily routine. Open communication with team members and supervisors via collaboration tools also helps address questions quickly and maintain coding accuracy.

What are Insurance Coders and what do they do in a remote role?

Insurance Coders, also known as medical coders, are professionals who review medical records and assign standardized codes to diagnoses and procedures for billing and insurance purposes. In a remote position, Insurance Coders work from home using secure online systems to access healthcare documentation and ensure accurate coding according to industry standards like ICD-10, CPT, and HCPCS. Their work helps healthcare providers receive proper reimbursement from insurance companies while ensuring compliance with regulations. Attention to detail and knowledge of medical terminology are essential in this role.

What is the difference between Insurance Coder Remote vs Medical Biller Remote?

AspectInsurance Coder RemoteMedical Biller Remote
CertificationsCertified Professional Coder (CPC), Certified Coding Associate (CCA)Certified Professional Biller (CPB), Certified Coding Associate (CCA)
Work EnvironmentRemote, healthcare offices, hospitalsRemote, healthcare offices, billing companies
Industry UsageHealthcare providers, insurance companiesHealthcare providers, billing services
Primary FocusAssigning codes to diagnoses and proceduresSubmitting claims and managing billing processes

While both Insurance Coder Remote and Medical Biller Remote roles work in healthcare and often share certifications, their primary responsibilities differ. Insurance coders focus on assigning accurate medical codes, whereas medical billers handle billing submissions and claims management. Both roles are essential in healthcare revenue cycle management and are commonly performed remotely.

What are popular job titles related to Insurance Coder Remote jobs in California? For Insurance Coder Remote jobs in California, the most frequently searched job titles are:
What job categories do people searching Insurance Coder Remote jobs in California look for? The top searched job categories for Insurance Coder Remote jobs in California are:
What cities in California are hiring for Insurance Coder Remote jobs? Cities in California with the most Insurance Coder Remote job openings:
Insurance Coder Remote jobs near you
Investigator, Special Investigative Unit Coding (Remote)

Investigator, Special Investigative Unit Coding (Remote)

Molina Healthcare

Long Beach, CA • Remote

Full-time

Posted 26 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

145th of 260 rated insurance

Job description

JOB DESCRIPTION
Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informational tips from member benefits and medical records following review of post-payment claims. 
Essential Job Duties
  • Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies.
  • Reviews post-pay claims against corresponding medical records to determine accuracy of claims payments. 
  • Manages documents and prioritizes caseloads to ensure timely turnaround. 
  • Ensures adherence to applicable state/federal/internal policies, Current Procedural Terminology (CPT) guidelines and provider contract requirements.
  • Devises clinical summary post-review.
  • Communicates and participates in meetings related to cases.
  • Completes medical review to facilitate referral to law enforcement or payment recovery. 
  • Supports investigation work as necessary and required by the regulatory agency.
Job Requirements
  • At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience.
  • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified
  • Critical-thinking, problem-solving and analytical skills. 
  • Ability to prioritize and manage multiple tasks.
  • Ability to work in a team setting.
  • Strong verbal/written communication skills, and presentation skills.
  • Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
  • In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements). 
  • Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations.
  • Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs.
  • Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems.
  • Ability to research and interpret regulatory requirements.
Preferred Qualifications
  • Certified Professional Compliance Officer (CPCO). 
  • Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). 
  • Experience working in group health insurance, particularly within claims processing or operations. 
  • Working knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.). 
  • Experience with claims processing systems. 
  • Ability to use Microsoft Excel/Access platforms working with large quantities of data. 
  • Ability to answer questions, identify trends and patterns, and present findings. 
 
To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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