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Job DetailsJob Location: Fresno - 1900 N Gateway - Fresno, CA 93727Position Type: Full TimeEducation Level: High SchoolSalary Range: $24.00 - $24.00 HourlyJob Category: Nonprofit - Social ServicesPOSITION SUMMARY: The CalAIM Billing Specialist is responsible for ensuring accurate and timely billing for CalAIM justice-involved pre-release services. This position supports program operations by verifying documentation, preparing billing submissions, monitoring reimbursement, and ensuring compliance with Medi-Cal and Managed Care Plan billing requirements. Essential Job Functions are below. ESSENTIAL JOB FUNCTIONS: •   Review program documentation to ensure services meet CalAIM, Medi-Cal, and Managed Care Plan billing requirements. •   Prepare and submit billing for CalAIM services, including Enhanced Care Management and applicable pre-release services. •   Verify eligibility, enrollment, and service authorization requirements prior to billing submission. •   Coordinate with program staff to ensure documentation supports billable services and meets required standards. •   Monitor billing activity, track claims submissions, and follow up on denied or pending claims. •   Work with Managed Care Plans to resolve billing discrepancies and reimbursement issues. •   Maintain accurate billing records and ensure timely submission of claims. •   Generate billing reports and provide updates to program leadership regarding billing status and reimbursement trends. •   Support compliance with regulatory and contractual billing requirements. •   Assist in the development and implementation of billing procedures related to CalAIM services. •   Embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation. •   Perform other duties as assigned.  QualificationsESSENTIAL QUALIFICATIONS: To perform this job successfully, an individual must be able to perform the duties and responsibilities satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Experience and Competencies: •   Strong attention to detail, organizational skills, and ability to manage multiple deadlines. •   Valid driver’s license and ability to obtain and maintain WestCare’s vehicle insurance is required. •   Ability to obtain and maintain successful background clearance. •   During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you. •   CPR Certification, First Aid Certification, and an annual Tuberculosis test. EDUCATION and/or EXPERIENCE: •   Experience with Medi-Cal, CalAIM, Enhanced Care Management, or healthcare billing preferred. •   Knowledge of healthcare documentation and billing practices. •   High school diploma or equivalent required; associate or bachelor’s degree preferred. LICENSURE/CERTIFICATION: •   Not applicable for this position. WORKING CONDITIONS: •   Work is performed in a combination of correctional facilities, office environments, and community settings. •   Regular interaction with justice-involved individuals and multidisciplinary care teams. •   Local travel is required to correctional facilities, partner agencies, and community providers. Â
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