Medical Billing Specialist (CPC)

Medical Billing Specialist (CPC)

at Zócalo Health

Remote, California residents only (Full Time) 

Compensation: $28- $32 per hour

About Us 

Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos. We are developing a new approach to care that is designed around our very own shared and lived experiences and brings care to our gente. Founded in 2021 on the idea that our communities deserve more than just safety nets, we are backed by leading healthcare and social impact investors in the country to bring our vision to life.

Our mission is to improve the lives of our communities—communities that have dealt with generations of poor experiences. These experiences include waiting hours in waiting rooms, spending mere minutes with doctors who don’t speak their language, and depending on their youngest kids to help them navigate our complex healthcare system. At Zócalo Health, we meet our members where they are, bringing care into their homes and neighborhoods through our team of community-based care providers and virtual care offerings.

We partner with community-based organizations, local healthcare providers, and health plans that recognize the value of culturally aligned care, which are not limited to brief interactions in an exam room. Together, we are building a new experience that revolves around the use of modern technology, culturally competent primary care, behavioral health, and social services to provide a radically better experience of care for every member, their family, and the communities we serve.

We are committed to expanding our reach to serve more members and their communities. We are looking for passionate individuals who share our belief that healthcare should be accessible, personalized, and rooted in the community. Join us in our mission to ensure that no one has to navigate the complexities of the healthcare system alone and that everyone receives the local, culturally competent care they deserve.

Role Description 

The Medical Billing Specialist (CPC) will join Zócalo Health at a critical time in the history of our company and of primary care. The opportunity for impact is large and growing, and Zócalo Health will lead the transition from fee-for-service to value-based care for the growing Latino community in the U.S. 

An integral member of the Revenue Cycle Management team, you will be responsible for supporting accurate, compliant, and timely medical billing across Primary Care, Urgent Care, and Behavioral Health services, including Medi-Cal managed care plans and Medi-Cal initiatives such as Enhanced Care Management (ECM), Community Health Worker (CHW), and Care Services (CS). This role applies certified coding expertise to ensure claims are reviewed, coded correctly, submitted in a timely manner, and followed through to resolution, including denial management. You will collaborate closely with Revenue Cycle stakeholders to support reimbursement accuracy, identify trends impacting claims performance, and contribute to continuous improvement as Zócalo Health scales value-based care for the communities we serve.

This position reports to the Revenue Cycle Management Team Lead. 

The Medical Billing Specialist (CPC)will contribute in the following ways:

• 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.

Qualifications

• 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.

Preferred Qualifications

• 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.

What you can expect from Zócalo Health

• Competitive salary: $28-$32 per hour (depending on experience)
• 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.

You must be authorized to work in the United States. 

At Zócalo Health Inc., we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at Zócalo Health are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. 

Those seeking employment at Zócalo Health are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.