Cal-AIM / Medi-Cal Biller

We are seeking a detail-oriented and organized Cal AIM / Medi-Cal Biller to join our team. The Cal AIM / Medi-Cal Biller is responsible for submitting, tracking, and resolving claims related to Medi-Cal, Cal AIM services, and behavioral health treatment services. This role works closely with clinical, admissions, utilization review, and finance teams to ensure accurate billing, compliance, and timely reimbursement.

The ideal candidate has experience with Medi-Cal regulations, DHCS requirements, revenue cycle management, and behavioral health documentation standards within substance use disorder and/or mental health treatment settings.

Submit and manage Medi-Cal and CalAIM claims accurately and timely; review client charts to ensure documentation supports billing requirements and medical necessity; verify client eligibility, authorizations, and insurance benefits; monitor claims for denials, rejections, and payment discrepancies; follow up on unpaid or denied claims and complete appeals when necessary; maintain compliance with DHCS, Medi-Cal, and payer guidelines; collaborate with admissions, case management, UR, and clinical staff regarding missing or incomplete documentation; ensure required assessments, treatment plans, progress notes, and consents are completed prior to billing; track authorizations, last covered dates, and billing deadlines; maintain accurate records of billing activity and claim status updates; assist with audits, corrective action plans, and compliance reviews as needed; communicate professionally with insurance companies, county representatives, and internal staff; stay updated on changes to CalAIM initiatives, Medi-Cal billing requirements, and behavioral health regulations.

Qualifications include minimum 1–2 years of experience in Medi-Cal, CalAIM, or behavioral health billing preferred; knowledge of DHCS regulations and behavioral health documentation standards; experience with substance use disorder (SUD) and/or mental health treatment billing preferred; familiarity with Kipu EMR or similar electronic medical record systems preferred; strong understanding of revenue cycle processes, authorizations, and claims management; excellent organizational skills and attention to detail; ability to work independently and manage multiple priorities; strong communication and problem-solving skills; proficient in Microsoft Office, Google Workspace, and electronic billing platforms.

Preferred qualifications: experience working in RTC, detox, PHP, and/or IOP settings; knowledge of CalAIM Enhanced Care Management (ECM) and Community Supports billing processes; prior experience handling audits or compliance-related billing reviews.

Work environment: position may be performed remotely or in-office depending on company needs; standard business hours with occasional flexibility based on billing deadlines and operational needs.

Physical requirements: prolonged periods of sitting and computer use; ability to communicate effectively via phone, video conferencing, and email.

Compensation and benefits include competitive salary based on experience; health benefits (if applicable); paid time off; opportunity for growth within the organization.