CalAIM Billing & Data Specialist Saint Mary's Community Services Stockton, CA Job Details Full-time $70,000
- $80,000 a year 11 hours ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Qualifications Employee relationship building Community relationship building Stakeholder relationship building Full Job Description
POSTION SUMMARY
The CalAIM Billing & Data Specialist is responsible for overseeing all aspects of CalAIM data integrity, electronic health records (EHR), Medi-Cal billing operations, revenue cycle management, reporting, quality assurance, and regulatory compliance for Enhanced Care Management (ECM), Community Supports (CS), Recuperative Care, and other DHCS-funded services. Why St. Mary's Community Services? Mission-Driven Leadership
- Be at the heart of an organization dedicated to serving the most vulnerable. Strategic Influence
- Shape policies and initiatives that uplift lives and drive systemic change. Collaborative Environment
- Work alongside a passionate team, community partners, and dedicated stakeholders. Sustainable Impact
- Lead an organization committed to long-term solutions for housing, healthcare, and social support.
Essential Duites & Responsibilities CalAIM Billing & Revenue Cycle Management Review claims for accuracy and compliance prior to submission. Manage authorization tracking and service eligibility verification. Monitor denied claims. Serve as a liaison with Managed Care Plans regarding billing issues. EHR Administration & Systems Management Support billing operations and assist with claims tracking and follow-up. Assist staff with EHR data entry, troubleshooting, and reporting needs. Provide onboarding and ongoing EHR training Compliance & Quality Assurance Conduct routine chart audits and documentation reviews. Assist leadership with documentation reviews and compliance tracking Data Management & Reporting Develop dashboards and performance reports. Monitor program outcomes and KPIs. Ensure accurate reporting to DHCS, MCPs, and leadership. Key Performance Indicators (KPIs): 95% Documentation compliance score 98% Data accuracy rate Working Environment This position operates primarily in a professional office environment. The employee will routinely use standard office equipment, including computers, telephones, printers, copiers, and other business technology. The role requires prolonged periods of sitting, frequent computer use, and regular communication with staff, clients, community partners, and stakeholders. The work environment is collaborative, fast-paced, and mission driven, requiring the ability to manage multiple priorities while maintaining professionalism and confidentiality.
What You Bring:
Bachelor's degree in Healthcare Administration, Public Health, Business Administration, Health Information Management, or a related field. Two to three years of experience in healthcare administration, medical billing, behavioral health operations, or CalAIM support services preferred. Experience with Medi-Cal, CalAIM, Enhanced Care Management, Community Supports, and Managed Care Plans preferred. Excellent relationship building skills with internal teams, community partners, and external stakeholders. Highly organized and adaptable, with strong communication and leadership skills. Bilingual English-Spanish speaking preferred.
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Vision Insurance Paid time off SMCS is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace that values and respects all individuals. Employment decisions are based on merit, qualifications, and business needs, without regard to race, color, religion, creed, national origin, ancestry, age, disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), gender, gender identity, gender expression, sexual orientation, military or veteran status, or any other status protected by applicable federal, state, or local laws.
