Medi-Cal Claims Specialist

The Medi-Cal Claims Billing Specialist will hold the crucial responsibility of inputting claims and corrections with precision and timeliness. Additionally, this role involves the monthly reconciliation of data between external and internal Electronic Health Record (EHR) systems. We are seeking an individual who is not only detail-oriented, but also embraces the opportunity to contribute to the seamless integration and accuracy of our healthcare data. 

Responsibilities:

• Generate billing reports from Welligent (WestCoast’s internal EHR) and input claims data into Alameda County’s EHR (Smart Care) and upload services to the City and County San Francisco EHR (EPIC).
• Collaborate with providers, supervisors, and county staff to complete billing process to 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.
• Prepares monthly invoices for Alameda and San Francisco Medi-Cal. 
• Monthly preparation of HCFA forms for OHC billings.

Key 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 is preferred.

Competencies (Skills, Abilities, and Knowledge):

• Ability to work independently and collaboratively as part of a team
• Strong ability to prioritize projects with competing deadlines
• Knowledge of issues of race, class, and ethnicity and experience working with diverse communities
• Solid understanding of processing Medi-Cal services and claims
• Experienced and knowledgeable with EHR systems; preferred experience with Smart Care, EPIC and/or Welligent EHR systems
• Excellent interpersonal, communication, and writing skills
• Knowledge of MS Office Suite including Excel, PowerPoint, Google Calendar, and Google Mail on a Mac OS platform

Position Details and Compensation:

This is a full-time, hourly position. Work location will be in-person at our offices in the Fruitvale district of Oakland, CA. Hourly rate is $26-$28 per hour ($54,080-$58,240 per year), and includes competitive benefits package, 403b and performance-based compensation plans.

Why work here?

-Be part of a compassionate, driven team that is social justice-focused: We have Staff Affinity Groups such as Staff of Color, LGBTQ , Equity and Inclusion, Health and Wellness, and more!

-Make a difference for the Bay Area’s most vulnerable populations: We serve hundreds of vulnerable kids and their families each year to create positive changes in their lives!

-Access a growth-oriented learning community: As a Joint Commission Accredited agency, we are dedicated to providing the highest standard of care, and offer extensive clinical trainings and seminars led by field experts. 

We also offer:

• 100% Employer-paid medical and a variety of different plans (base plan, Kaiser HMO), dental, vision, life insurance, and long-term disability coverage for full-time employees. 50% paid coverage for dependent medical and dental.
• Annual incentive compensation plans, generous retirement plan contribution
• 403b retirement plan with ROTH and 403b contribution options
• Flex-spending options - Medical, Dependent Care and Commuter Plans
• 14 Paid Holidays, Self-Care Leave (additional PTO accrual with increased years of service)
• 15 days paid time off per year (equivalent to 3 weeks)
• Wellness Stipend ($100 per month), which can be used on a variety of expenses related to self-care and wellness

Salary : $54,080 - $58,240