Calaim Medical Billing Specialist

4 weeks ago

Grass Valley, United States Foothill House of Hospitality (dba Hospitality Hou Full time

***

Under the supervision of the CalAIM Program Manager, the CalAIM Medical Billing Specialist is responsible for performing Hospitality House’s California Advancing and Innovating Medi-Cal (CalAIM) Medi-Cal Billing. This includes referral submission, claims submission, data collection compliance, and relevant reporting as required by the CalAIM program. This position requires a high level of professionalism and a friendly demeanor in a fast-paced, social services office setting.

Rate of Pay

$26.00 - $28.00 per hour.

**Benefits**:

- Medical Insurance.
- Dental Insurance.
- Vision Insurance.
- Life Insurance.
- Long-term Disability Insurance.
- Voluntary Short-term Insurance.
- 401k.
- 11 paid holidays.
- 11 paid sick days.
- 5 paid vacations in first year (gradual increases commensurate with seniority).

**ESSENTIAL DUTIES AND RESPONSIBILITIES**

CalAIM Responsibilities
- Ensure all CalAIM medical billing is completed accurately, on time, and in accordance with State regulations.
- In coordination with the CalAIM Program Manager, maintain confidential CalAIM and client/guest files.
- Under the direction of the CalAIM Program Manager, ensure Hospitality House’s compliance with all CalAIM requirements.
- Reconcile incoming invoices, billing statements, and payment statements accurately and on time.
- Complete and submit escalation templates and reports for any non-payment of billed services from the managed care plans.
- In coordination with the Director of Strategic Programming, follow up on and ensure CalAIM provider portals are up-to-date and accurate.
- Understand and adhere to Health Insurance Portability and Accountability Act regulations.
- Stay abreast of ever-evolving CalAIM regulations and compliance modifications.
- Provide general office administrative duties as assigned.

Duties as a Hospitality House Employee
- Serve as an agency ambassador.
- Adhere to staffing schedules in order to provide adequate/safe staffing coverage and to accomplish program objectives.
- Foster open and collaborative relationships with other team members and management.
- Develop healthy community relationships and maintain a positive program image.
- Maintain working knowledge of fire, safety, health, and work standards to help provide a safe and positive environment for all.
- Ensure confidentiality and data privacy standards are met or exceeded at all times.
- Recognize and perform the duties of a mandated reporter as outlined in federal, state, and local regulations as appropriate.
- Ensure agency programs are available to eligible residents regardless of religious belief or affiliation, race, color, national origin, handicap, or sexual orientation.
- Assist at Hospitality House sponsored events as needed.
- Maintain grounds security at all times.
- Travel as required.
- Other duties as assigned.

**ATTENDANCE**

Must be punctual and timely in meeting all requirements of performance, including, but not limited to, attendance standards and work deadlines; beginning and ending assignments on time; and scheduled work breaks, where applicable.

**BUSINESS NECESSITY**

The needs of Hospitality House may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and client demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with mínimal or no advance notice to employees. Accordingly, the employee must be capable of adapting with mínimal or no advance notice, to change in how business is conducted, and work is accomplished, with no diminishment in work performance.

**SAFETY AND SECURITY**

All employees are responsible for observing safety and security procedures as applicable and reporting potentially unsafe conditions to management.

**SUPERVISORY RESPONSIBILITIES**

The CalAIM Billing Specialist has no direct reports and no supervisory responsibilities.

**EDUCATION AND/OR EXPERIENCE**

Associate degree (AA) or equivalent from a two year college or technical school; or one to two years related experience.

**LANGUAGE SKILLS**

Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures and/or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public.

**COMPUTER SKILLS**

To perform this job successfully, an individual should have intermediate skills in the following: Microsoft 365 including Word, Excel, PowerPoint, and Outlook, Adobe Acrobat, and Google.

**CERTIFICATES, LICENSES, REGISTRATIONS**

Must have a current and valid driver’s license.

**OTHER SKILLS, ABILITIES, AND **QUALIFICATIONS
- An interest in worki

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