Nonprofit Medi-Cal Claims Specialist

WestCoast Children’s Clinic, located in Oakland, California, is a non-profit community psychology clinic that provides mental health services to Bay Area children, youth and families. Working at WestCoast Children’s Clinic means being part of an organization that is client-centered, trauma-informed, collaborative, and committed to justice and equity. 

Position Details 

Title: Medi-Cal Claims Billing Specialist

Classification: Full time (1.0 FTE) Non-Exempt, 40 hours per week

Location: Oakland, CA / In-person 

Regular Work Schedule: Monday - Friday

Compensation: 

• Hourly range: $26.00-$28.00 per hour

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

Benefits:

• Employer-paid Medical Benefits for Employees 
  • 100% employer-paid dental and vision 
  • Dependent medical, dental and vision (50% employer-paid) 
• Medical and Dependent Care FSA and commuter plans
• 100% employer-paid life insurance long-term disability insurance
• Voluntary accident, term life and hospital indemnity insurance 
• 403(b) and ROTH retirement plan options, employer contribution targeted at 7.5% after first year of employment
• Three weeks PTO during the first year of employment, 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 ($100.00 per month)
• Employee Assistance Program (EAP)

Join us and make a difference in the lives of vulnerable children and families in the Bay Area.  

WCC is passionate about leading and encouraging open conversations around race, gender, power, and privilege and how these impact community mental health. We are an equal opportunity employer. We are committed to diminishing the influence of privilege and discrimination in our field and our workplace, whether due to differences concerning age, citizenship, color, disability, marital or parental status, race, religion, gender, or sexual orientation.