CalAIM Billing Specialist — ECM & Community Supports

DaMar Staffing; United States; On-site; USD 53,000 - 71,000; Full time

Job summary

DaMar Staffing seeks a Medical Biller for Cal AIM Services to accurately bill and process claims for ECM, Recuperative Care, CS, detox billing, and other Cal AIM services. This role ensures timely submission, compliance with DHCS and MCP requirements, and coordination with clinical and data teams to support revenue integrity.

Responsibilities include verifying eligibility, ensuring documentation meets billing standards, reconciling claims, and communicating with managed care plans.

Qualifications

• High school diploma or equivalent.
• 5-7 years of medical billing experience.
• Knowledge of Medi-Cal or Medicaid billing processes.
• Strong data entry accuracy and attention to detail.
• Ability to review clinical documentation and apply billing rules.
• Experience with CalAIM, ECM, or Community Supports billing.
• Familiarity with DHCS/health plan portals.
• Proficient computer skills, with intermediate proficiency in MS Office (Word, Excel, and PowerPoint).

Responsibilities

• Prepare, submit, and track claims for ECM, Recuperative Care, Community Supports, detox billing, and other Cal AIM service lines.
• Verify eligibility and authorization requirements for all Cal AIM beneficiaries.
• Ensure documentation meets Cal AIM billing standards, including encounter data, activity logs, and service notes.
• Reconcile encounters and claims to identify discrepancies or missing documentation.
• Process claims corrections, resubmissions, and voids as needed.
• Collaborate with ECM/CS/RCP program staff, care managers, and supervisors (stakeholders) to clarify documentation needs and share reconciliation reports of reimbursements.
• Communicate with Managed Care Plans regarding claim follow-up, denials, Appeals, and payment discrepancies.
• Provide feedback and training to program staff regarding billing requirements and documentation best practices.
• Maintain accurate records of claims, payments, denials, Appeals, and adjustments.
• Generate billing reports, productivity summaries, and revenue tracking related to Cal AIM services.
• Support audits and data validation efforts as required.
• On time, completion of assigned training and policies.
• Performs other duties as assigned.

Skills

Medical billing experience

Data entry accuracy

CalAIM/Medicaid billing

Education

High school diploma

Tools

MS Office

Job description

DaMar Staffing seeks a Medical Biller for Cal AIM Services to accurately bill and process claims for ECM, Recuperative Care, CS, detox billing, and other Cal AIM services. This role ensures timely submission, compliance with DHCS and MCP requirements, and coordination with clinical and data teams to support revenue integrity.

Responsibilities include verifying eligibility, ensuring documentation meets billing standards, reconciling claims, and communicating with managed care plans.