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Remote Medicare Claims Processing Jobs in California

Medical Claims Examiner

Los Angeles, CA ยท On-site +1

$24 - $30/hr

Paid time off, flexible schedule, and remote work choices provided Plus, we work to maintain the ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.

Medical Claims Examiner

CA ยท On-site +1

$24 - $30/hr

Description & Requirements Medical Claims Examiner- Chatsworth Local Remote or In-Office Join a ... Solid knowledge of Medicare and Medi-Cal managed care claims processing and compliance guidelines.

Director of Claims- Healthcare

Chatsworth, CA ยท On-site +1

$130K - $160K/yr

Paid time off, flexible schedule, and remote work one day per week Plus, we work to maintain the ... Strong knowledge of Medicare and Medi-Cal managed care claims processing, reimbursement ...

What to Expect This is a fully remote position supporting claims operations. Team members spend the majority of their day reviewing and processing claims, working extensively with computer systems ...

$23/hr

Remote (Candidate should be based in SoCal) Pay : $23/hr Overview of Responsibilities: We are ... The selected candidate should be familiar with HMOs, claims processing, and authorization/referral ...

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Remote Medicare Claims Processing information

What is remote Medicare claims processing?

Remote Medicare claims processing involves reviewing, verifying, and submitting medical claims to Medicare from a location outside of a traditional office, often from home. Professionals in this role ensure that healthcare providers are reimbursed for services rendered to Medicare patients by checking claims for accuracy, compliance, and eligibility. They use specialized software to process electronic and paper claims, resolve discrepancies, and follow up on denied or delayed payments. This job requires knowledge of Medicare regulations, coding, and strong attention to detail. Remote work allows for flexible scheduling but also demands self-discipline and secure handling of sensitive patient data.

What are the key skills and qualifications needed to thrive as a remote Medicare claims processor?

To thrive as a Remote Medicare Claims Processor, you need strong attention to detail, knowledge of medical billing and coding, and a solid understanding of Medicare regulations, often supported by a relevant certification like CPC or CCA. Familiarity with claims processing software, electronic health record (EHR) systems, and Medicare-specific platforms such as the Fiscal Intermediary Standard System (FISS) is typically required. Strong organizational skills, effective written communication, and problem-solving abilities help you excel in remote work environments. These skills ensure timely and accurate claims processing, minimize errors, and support compliance with complex healthcare regulations.

What are some common challenges faced by remote Medicare claims processors and how can they be managed?

One common challenge for remote Medicare claims processors is staying up-to-date with frequent changes in Medicare regulations and billing codes. Additionally, working remotely can make it harder to quickly clarify complex cases with colleagues or supervisors. To manage these challenges, it's important to participate in regular training sessions, utilize internal communication platforms for collaboration, and maintain organized documentation. Employers often provide digital resources and support channels to help remote processors stay connected and informed.

What is the difference between Remote Medicare Claims Processing vs Remote Medical Billing Specialist?

AspectRemote Medicare Claims ProcessingRemote Medical Billing Specialist
CertificationsCPAR, CPC, or similarCPB, CPC, or similar
Work EnvironmentHealthcare insurance, government programsHealthcare providers, clinics, hospitals
Job FocusSubmitting and managing Medicare claimsBilling for various medical services and insurance

Remote Medicare Claims Processing involves handling claims specifically for Medicare, focusing on government regulations and Medicare-specific procedures. Remote Medical Billing Specialists manage billing for a variety of insurance types and healthcare providers. While both roles require similar certifications and work remotely in healthcare settings, Medicare Claims Processing is specialized in government insurance claims, whereas Medical Billing covers broader insurance billing tasks.

What are the most commonly searched types of Medicare Claims Processing jobs in California?

The most popular types of Medicare Claims Processing jobs in California are:

What are popular job titles related to Remote Medicare Claims Processing jobs in California?

For Remote Medicare Claims Processing jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Medicare Claims Processing jobs in California look for?

The top searched job categories for Remote Medicare Claims Processing jobs in California are:

What cities in California are hiring for Remote Medicare Claims Processing jobs?

Cities in California with the most Remote Medicare Claims Processing job openings:

Infographic showing various Remote Medicare Claims Processing job openings in California as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 11% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Claims Processing Expert - Fully Remote | Upto $80/hr

San Francisco, CA โ€ข Remote

$80/hr

Full-time

Re-posted 26 days ago


Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Medical Billing Manager
Type: Contract
Compensation: $80/hour
Location: Remote

Role Responsibilities

  • Oversee end-to-end medical billing and claims submission operations across professional fee and/or facility billing environments.
  • Evaluate AI-generated billing outputs, claim edits, and coding validations for accuracy and payer compliance.
  • Manage claims submission workflows including electronic claim generation, clearinghouse edits, and payer-specific billing requirements.
  • Monitor clean claim rates, rejection rates, and first-pass acceptance rates. Develop improvement strategies.
  • Coordinate with coding, CDI, and collections teams to resolve billing edits and claim rejections.
  • Ensure compliance with CMS billing guidelines, HIPAA 837 transaction standards, and payer-specific billing rules.
  • Annotate AI outputs and provide structured feedback to support AI training datasets.

Qualifications

Must-Have

  • 5+ years of experience in medical billing and claims management, with at least 2 years in a management role.
  • Deep knowledge of professional fee (CMS-1500/837P) and/or facility (UB-04/837I) billing requirements.
  • Expertise in HIPAA 837 transaction standards, clearinghouse operations, and payer-specific billing rules.
  • Strong understanding of Medicare, Medicaid, and commercial payer billing requirements.
  • Proficiency with billing platforms (Epic, Athenahealth, AdvancedMD, or equivalent) and clearinghouse tools.
  • Exceptional written and verbal English communication skills.
  • High attention to detail with the ability to identify billing errors and compliance issues in AI-generated outputs.

Preferred

  • CPC, CCS, CHFP, or CRCR certification.
  • Experience with automated billing platforms and RCM technology implementations.
  • Background in multi-specialty physician group, hospital, or health system billing operations.
  • Familiarity with AI tools and comfort evaluating AI-generated billing content.
  • Experience with payer contract interpretation and billing compliance program management.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.