Nonprofit Medi-Cal Claims Specialist

Position Overview

Title: Medi-Cal Claims Billing Specialist

Classification:

Location:

Regular Work Schedule:

The Medi-Cal Claims Billing Specialist holds the crucial responsibility of inputting claims and corrections with precision and timeliness. This role also includes the monthly reconciliation of data between external and internal Electronic Health Record (EHR) systems, ensuring a seamless integration and accuracy of healthcare data.

Key Responsibilities

• Generate billing reports from Welligent and input claims data into Alameda County's EHR (Smart Care) while uploading services to the City and County San Francisco EHR (EPIC).
• Collaborate with providers, supervisors, and county staff to complete the billing process and correct claims.
• Reconcile monthly claims generated from Smart Care and EPIC systems to internally generated reports.
• Prepare and submit Correction Claim Reports for Alameda and San Francisco with appropriate supporting documentation.
• Prepare monthly invoices for Alameda and San Francisco Medi-Cal and handle the preparation of HCFA forms for OHC billings.

Required Qualifications

• BA/BS degree (preferred)
• Minimum one year of experience with Microsoft Office applications (Excel and Word)
• At least one year of experience with Google Suite
• Professional experience in an office setting
• At least one year of experience with Medi-Cal billing procedures and processes (preferred)
• Ability to work independently and collaboratively as part of a team
• Strong ability to prioritize projects with competing deadlines
• Understanding of race, class, and ethnicity issues with experience working with diverse communities
• Solid understanding of processing Medi-Cal services and claims
• Experience with Electronic Health Record (EHR) systems, preferably Smart Care, EPIC, and/or Welligent
• Excellent interpersonal, communication, and writing skills
• Proficiency in MS Office Suite including Excel and PowerPoint, along with experience using Google Calendar and Google Mail on a Mac OS platform

Benefits & Perks

• Employer-paid Medical Benefits for Employees
• 100% employer-paid dental and vision
• Dependent medical, dental, and vision coverage (50% employer-paid)
• Medical and Dependent Care FSA and commuter plans
• 100% employer-paid life insurance and long-term disability insurance
• Voluntary accident, term life, and hospital indemnity insurance
• Annual incentive compensation (10% per year)
• 403(b) and ROTH retirement plan options with an employer contribution targeted at 7.5% after the first year
• Three weeks PTO during the first year; 4+ weeks PTO with additional years of service
• 12 paid holidays plus one paid floating holiday per year
• 4 paid self-care days per year
• Wellness stipend of $100.00 per month
• Employee Assistance Program (EAP)