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Volunteers of America Los Angeles · 1 day ago

CalAIM Billing Specialist II

Los Angeles, CA

Full-time

Onsite

Entry Level

$25.65/hr - $27/hr

2+ years exp

Volunteers of America Los Angeles is a non-profit human services organization committed to serving people in need. The CalAIM Billing Specialist II is responsible for reviewing, submitting, and tracking claims for the Health Supportive Services division, ensuring billing accuracy and providing support to program staff.

Non ProfitSocial

Responsibilities

The CalAIM Billing Specialist will ensure clean CS Housing and ECM claims are submitted through the billing portal and clearinghouse

Monitor billing errors that could involve issues around data entry for services in queue (i.e. units of services, time start and end time, etc.) and notify responsible parties to make timely corrections

Monitor and review denied claims and resubmit with corrected billing errors

Track all payments and ensure they are posted in the billing portal and all accounting systems

Support, coach, and train CalAIM program staff and team members in billing processes

Maintain and store all billing supportive documentation in designated Information System, as required by State guidelines

Assist in maintaining confidential records of members served

Maintain active accounts in all billing-related and Insurer portals

Conduct program site visits, as assigned by need

Develop, record, and distribute monthly reports, and/or general information, as needed

Support, as needed, with generating CalAIM services in billing portal and submit to designated Program Leadership

Assist leadership in reconciling data, as needed

Interact with accounting to ensure accuracy in billing and payments received

Remain current in updates made by Insurers, the state, and other regulatory bodies to ensure ongoing compliances and upholding best billing practices

Other duties as may be assigned by CQI Leadership

Submit clean claims in billing portals

Monitor and support in correcting billing errors

Resubmit denied claims with necessary corrections

Track and document claims payments

Train and coach CalAIM team members

Other duties as required and is subject to change at any time

Qualification

Medi-Cal billing experienceElectronic Health Record operationsBilling submissionsData-driven environmentTrainingCoachingQuality assuranceClaims trackingClaims monitoringConfidential record maintenance

Required

Must be able to pass a fingerprint clearance, background check, including criminal history, personal references, employment and education verifications

Associate Degree or equivalent combination of education and work experience (2 years of relevant experience / coursework)

1 year of experience with billing

2 years of experience in Electronic Health Record database operations and/or billing submissions

1 year of experience in data-driven and/or quality assurance environment