Consultex Practice Management, Inc. · 5 days ago
Billing Specialist – CalAIM (Behavioral Health)
United States
Full-time
Remote
Mid Level
$25/hr - $38/hr
4+ years expConsultex Practice Management is seeking a Billing Specialist with CalAIM experience to support their growing portfolio of behavioral health providers across California. This role focuses on accurate claim submission, denial resolution, and AR follow-up for CalAIM Community Supports and outpatient behavioral health services.
BillingInsuranceMedical
Responsibilities
Submit and manage CalAIM claims across Medi-Cal Managed Care Plans (IEHP, LA Care, Anthem, Health Net, etc.)
Review encounters for billing accuracy, required documentation, and authorization alignment
Perform denial analysis and correction (eligibility, auth mismatch, service code issues, documentation gaps)
Manage AR follow-up and payment posting
Coordinate with internal UR and clinical teams to resolve billing blockers
Monitor payer rules and assist with updates to billing workflows as CalAIM guidance evolves
Support reporting related to submissions, denials, and payment trends
Maintain payer portal activity and documentation logs
Qualification
Required
4+ years of behavioral health billing experience
Direct experience billing CalAIM and/or Medi-Cal Managed Care Plans strongly preferred
Solid understanding of Community Supports billing
Solid understanding of Medi-Cal authorization workflows
Solid understanding of behavioral health coding and billing logic
High attention to detail and ability to manage multiple payers/programs
Strong written communication and documentation skills
U.S.-based (this role cannot be offshore)
Preferred
Experience with CalAIM Community Supports (ECM, Housing Navigation, Tenancy, Sustaining Services)
Experience working within an outsourced RCM or multi-client environment
Understanding of pass-through expense billing and reconciliation
Company
Consultex Practice Management, Inc.
Complete medical billing and revenue solutions customized to your practice.
2-10 employees
Funding
Current Stage
Early StageLeadership Team
Candice Utush
Chief Executive Officer
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