Billing & Claims Specialist - Medi-cal Calaim

2 weeks ago

Dublin, United States Omatochi Corp Full time

**About Omatochi**:
Omatochi is a leading home care service provider dedicated to enhancing the quality of life for our clients. We specialize in delivering compassionate and high-quality care with a focus on personalized solutions. As we continue to grow, we are seeking a skilled Billing Specialist to join our team and contribute to the success of our Medi-Cal CalAIM program.

**Job Overview**:
**Responsibilities**:
**Claims Processing**:
- Accurately prepare and submit claims for services rendered to Medi-Cal CalAIM, ensuring compliance with program guidelines and regulations.
- Review and verify the completeness of claims documentation, resolving any discrepancies or issues promptly.

**Billing and Reimbursement**:
- Collaborate with internal teams to gather necessary information for billing purposes.
- Monitor reimbursement activities, identifying and addressing any billing errors or discrepancies.

**Program Compliance**:
- Stay updated on changes to the Medi-Cal CalAIM program regulations, policies, and billing procedures.
- Ensure strict adherence to program requirements and maintain compliance with all relevant guidelines.

**Documentation and Record-Keeping**:
- Maintain accurate and organized records of billing transactions, claims submissions, and related documentation.
- Prepare reports and summaries as required for internal and external audits.

**Communication and Collaboration**:
- Communicate effectively with internal stakeholders, including care managers and administrative staff, to address billing-related inquiries and resolve issues.
- Collaborate with external entities, including Medi-Cal representatives and regulatory bodies, to facilitate smooth billing processes.

**Qualifications**:

- Bachelor's degree in Healthcare Management, Business Administration, or a related field.
- Minimum of 3 years of experience in billing and claims processing, with a focus on Medi-Cal programs.
- In-depth knowledge of the Medi-Cal CalAIM program regulations, guidelines, and billing procedures.
- Proficiency in using billing software and electronic health record (EHR) systems.
- Strong attention to detail and accuracy in claims submission and documentation.
- Excellent communication skills and the ability to collaborate effectively with cross-functional teams.
- Familiarity with relevant laws and regulations governing healthcare billing practices.

**What We Offer**:

- Competitive salary commensurate with experience.
- Comprehensive benefits package, including health insurance plans.
- Opportunities for professional development and career advancement.
- A supportive and inclusive work environment.

  • Medical Only Claims Specialist

    2 weeks ago

    Dublin, United States CorVel Corporation Full time

    The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.  This is a hybrid role reporting to our Dublin, OH office. Candidates must live within 30 minutes of Dublin, OH to be...

  • Medical Only Claims Specialist

    2 weeks ago

    Dublin, United States CorVel Enterprise Comp, Inc. Full time

    Job DescriptionJob DescriptionThe Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel. This is a hybrid role reporting to our Dublin, OH office. Candidates must live within 30 minutes of...

  • Medical AR Specialist

    2 months ago

    Dublin, United States Columbus Oncology & Hematology Full time

    Job DescriptionJob DescriptionColumbus Oncology and Hematology is looking for a full-time Medical AR Specialist to join our team! Columbus Oncology and Hematology Is a private practice that offers services at three locations throughout the Columbus area. The Medical AR Specialist is responsible for following up with insurance carriers on unresolved and aged...

  • Payment Operations Specialist

    2 weeks ago

    Dublin, United States Insight Global Full time

    A client of Insight Global is looking for a Payment Operations Specialist to sit out of their headquarters in Dublin, OH. The Payment Operations Specialist will have a deep working knowledge of credit and debit card services, payment card network rules relating to chargebacks, and familiarity with Regulation E, and best practices of the same. This role will...

  • Senior Specialist

    4 weeks ago

    Dublin, United States Ross Stores, Inc. Full time

    Respond to Vendor inquiries regarding invoice status, payment details, shortage claims, and other miscellaneous payment deductions in a timely and professional manner. Identify and resolve issues that result in late payments to ensure future payments Vendor, Specialist, Merchandise, Senior, Payment, Retail, Business Services, Skills

  • Remote-brazilian portuguese business coordinator

    3 days ago

    Dublin, United States Randstad Full time

    Are you fluent in Brazilian Portuguese and have at least 1 year of office experience? Ideally, do you also have experience within the insurance industry? Do you enjoy working with a high volume of details, processing information from numerous computer software systems, investigating and documenting, and interacting with customers? This Claims Specialist role...

  • AP Specialist

    5 days ago

    Dublin, Ohio, United States Vaco Full time

    Accounting Professionals-don't let your resume get lost in the shuffleLet Vaco serve as your advocate in presenting you to our top clients who are looking for accounting professionals. Our clients have immediate opportunities for Accounts Payable Specialists; don't let your resume get lost in the shuffle - let us work for you At Vaco, we give you anadvantage...

  • Cash Application Specialist

    5 days ago

    Dublin, Ohio, United States Vaco Full time

    Accounting Professionals-don't let your resume get lost in the shuffleLet Vaco serve as your advocate in presenting you to our top clients who are looking for accounting professionals. Our clients have immediate opportunities for Cash Applications Specialists; don't let your resume get lost in the shuffle - let us work for you At Vaco, we give you...

  • Cash Application Specialist

    5 days ago

    Dublin, United States Vaco Full time

    Accounting Professionals-don't let your resume get lost in the shuffle! Let Vaco serve as your advocate in presenting you to our top clients who are looking for accounting professionals. Our clients have immediate opportunities for Cash Applications Specialists; don't let your resume get lost in the shuffle - let us work for you! At Vaco, we give you an...

  • Senior Sales Enablement Specialist

    2 weeks ago

    Dublin, United States SS&C Full time

    SS&C is a global provider of investment and financial services and software for the financial services and healthcare industries. Named to Fortune 1000 list as top U.S. company based on revenue, SS&C is headquartered in Windsor, Connecticut and has 20,000+ employees in over 90 offices in 35 countries. Some 18,000 financial services and healthcare...

  • Patient Care Coordinator

    2 weeks ago

    Dublin, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your...

  • Customer Support Specialist

    4 days ago

    Dublin, United States Kinetics Noise Control Full time

    Job DescriptionJob DescriptionCustomer Support SpecialistKinetics Noise Control, Inc. (“Kinetics”) has extensive experience designing and manufacturing innovative products to control noise and vibration. Established in 1958 as industrial consultants focused on controlling sound and vibration, Kinetics now produces the industry’s largest selection of...

  • Senior Specialist

    4 days ago

    Dublin, United States Ross Full time

    GENERAL PURPOSE: Respond to Vendor inquiries regarding invoice status, payment details, shortage claims, and other miscellaneous payment deductions in a timely and professional manner. Identify and resolve issues that result in late payments to ensure future payments are made timely. Maintain strong vendor relations for assigned vendors by ensuring their...

  • Commercial Sales Manager

    5 days ago

    Dublin, United States AutoZone Full time

    The Commercial Sales Manager is responsible for driving the commercial sales within their AutoZone location. The CSM develops and maintains positive relationships with commercial customers by managing the acquisition and delivery of products, providing ongoing customer service, and maintaining expert knowledge on parts and inventory. The CSM exceeds...

  • Accounting Specialist

    4 weeks ago

    Dublin, United States Community Service Board of Middle Georgia - PEO, Ltd. Full time

    Job DescriptionJob DescriptionThe Community Service Board of Middle Georgia is dedicated to providing those we serve with quality innovative behavioral healthcare in a recovery-based environment. CSB of Middle Georgia is recognized as a state leader in comprehensive behavioral healthcare providing integrated cost-effective services. CSB of Middle Georgia is...

  • Director of Nursing

    4 weeks ago

    Dublin, United States Surgery Care Affiliates Full time

    Overview Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of...

  • Director of Nursing

    3 weeks ago

    Dublin, United States SCA Health Full time

    Overview:Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality...

  • Sterile Processing Coordinator

    3 weeks ago

    Dublin, United States SCA Health Full time

    Overview:Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality...

  • Sterile Processing Coordinator

    2 weeks ago

    Dublin, United States SCA Health Full time

    Overview:Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality...

  • Sterile Processing Coordinator

    3 weeks ago

    Dublin, United States SCA Health Full time

    Overview Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality...