CalAIM Medical Biller

Medical Biller The Medical Biller plays a key role in supporting the mission of our nonprofit organization by ensuring the accurate and timely submission of claims for services rendered to Medi-Cal beneficiaries. This position focuses on billing related to CalAIM initiatives, including Enhanced Care Management (ECM) and Community Supports (CS), and is essential to maintaining the financial health and sustainability of our community-based programs.

Key Responsibilities:

Prepare and submit claims to Medi-Cal and managed care plans for ECM and Community Supports services. Verify service eligibility and authorizations to ensure compliance with Medi-Cal billing requirements. Coordinate with care management and program staff to collect accurate documentation for billing. Monitor the status of submitted claims and follow up on unpaid, denied, or rejected claims. Resolve billing errors and resubmit claims as needed. Maintain accurate billing and collections records in alignment with nonprofit and funder audit standards. Provide regular reports to the Finance Director regarding billing performance, revenue trends, and outstanding balances. Stay informed on changes to Medi-Cal, CalAIM, and managed care billing requirements. Serve as a liaison with Medi-Cal managed care plans to address billing questions or issues. Contribute to the improvement of billing processes and financial workflows to support organizational goals.

Qualifications:

High school diploma or equivalent required; medical billing certification or Associate's degree preferred. At least 2 years of medical billing experience, ideally in a nonprofit or Medi-Cal environment. Knowledge of Medi-Cal billing procedures, including familiarity with CalAIM, ECM, and Community Supports. Understanding of CPT, HCPCS, and ICD-10 coding systems. Proficiency in billing software and electronic health record (EHR) systems. Strong attention to detail and ability to meet deadlines. Excellent interpersonal and communication skills, with the ability to collaborate across teams. Commitment to the mission and values of nonprofit, community-centered healthcare.

Pay:

$22.00 - $24.00 per hour

Benefits:

Dental insurance Employee assistance program Health insurance Life insurance Paid time off Vision insurance

Work Location:

In person