Job Description
- Required Qualifications
- Minimum 3 years of DMH billing experience.
- Proficient in interpreting Medi-Cal, Other Health Coverage, and Medicare eligibility codes (e.g., A, P, F, C).
- Familiarity with CalAIM initiatives and related updates impacting billing and claims.
- Experience with DMH claiming timelines, including submission deadlines and re-submission protocols.
- Solid understanding of the Medicare appeals process.
- Experience with Avatar SIFT data and staying current with CalAIM updates.
- Strong written and verbal communication skills.
- Proficiency in Microsoft Word, Excel (pivot tables), and SQL.
- Familiarity with Power BI or Tableau for data visualization.
- Knowledge of Claim Adjustment Reason Codes (CARC),
- Excellent time management, organization, and attention to detail; self-motivated and proactive.
- Preferred Qualifications
- Bilingual (Spanish) preferred but not required.
- Experience with Welligent or other EHR systems.
- Background in healthcare collections.
- Typing speed of at least 35 wpm.
- DMH medical record documentation requirements.
- Ability to perform cross-coverage and take on additional duties as needed.
Systems:
Welligent, Covivitas, Availity, Inovalon, DMH Avatar (Sift), Power BI,
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