Cal AIM Data Specialist

TLCS•Sacramento, CA

1d•Onsite

About The Position

The CalAIM Data Specialist, reporting to the CalAIM Program Manager, ensures accuracy, compliance, and efficiency of CalAIM service delivery. This role supports the revenue cycle by reviewing authorizations and claims, identifying errors, monitoring billing trends, and ensuring adherence to payer rules, coding guidelines, and internal standards. The ideal candidate is detail-oriented, highly organized, and experienced in behavioral health billing practices.

Requirements

High School diploma or equivalent
Demonstrated experience with Medi-Cal billing and EHR System.
Two (2) years of office work experience with attention to details.
Possess a valid California Driver’s License and current vehicle insurance.
Driving records must meet, and continue to meet, the underwriting standards established by the generalized driving guidelines used by our insurance broker.
Must provide proof of insurance.
Must have at least 3 or more years of driving experience.
Ability to pass clearance of the Federal Bureau of Investigation (FBI) and/or Department of Justice (DOJ) background screenings

Nice To Haves

Consumer of mental health services or a family member of a mental health consumer is desirable

Responsibilities

Verify correct entry into the EHR systems utilized by CalAIM (Salesforce and HMIS), ensure completeness of EHR forms, prepare and submit any EHR claims correction spreadsheets to the EHR liaison for submission to partnering care plans.
Build new client profiles within SalesForce upon receipt of referrals ensuring accuracy and entry of required information
Maintain authorization status through the duration of services provided
Maintain census data for services provided within residential sites
Check and update monthly Medi-Cal eligibility for all CalAim clients.
Work with billing entities including consultants to ensure accuracy of billing claims
Act as liaison to partnering care plans attending meetings, consultations, and trainings as needed
Accurately complete all necessary forms, reports and paperwork required by the program on a timely basis.
Conduct service report reviews across program to ensure accuracy and compliance
Ensuring billing accuracy and making necessary corrections.
Coordinate, or assist in, projects as directed, including creating, preparing and distributing special reports as needed or assigned.
Act as a designated Mandated Reporter for the observed or suspected abuse and/or neglect of children, disabled individuals, dependent adults and elder/senior citizens. Mandated Reporter also includes “Duty to Warn” which includes the responsibility to notify authorities and the intended victim(s) of physical harm.
Ensure the protection and confidentiality of all Protected Health Information (PHI) by following all policies and procedures in the HIPAA Manual.
Regular and predictable attendance required.
Use motivational interviewing, trauma-informed care, and harm-reduction practices

Benefits

21 PTO days per year (4 weeks & 1 day)
26 PTO days after the 5 th year (5 weeks & 1 day)
6 days paid sick time
11 paid holidays
1 Personal Day
Leadership Development Reimbursements
Eligible for Government Loan Forgiveness Programs
Employer-paid health insurance for employees and children (Kaiser, Sutter or Western Health Advantage)
HSA Contributions
Flexible Spending Account
401k match
PTO Cash Out
Voluntary Dental, Vision, Life Insurance, Accident Insurance, Disability Insurance and more
Employee Assistance Program
Regular wage step scale increases
Flexible start/end times for some positions
iPhone with unlimited data for personal/professional use and laptop for some positions
Clinical Supervision towards licensure (for certain positions and upon approval)
CEU days for certain positions
Up to $500 CEU allowance for certain positions
Annual BBQ and staff appreciation awards
Annual Gift Card Program
Referral Bonuses