DMC Billing & Documentation QA Specialist

NATIONAL COUNCIL ON ALCOHOLISM; Los Angeles (CA); On-site; USD 75,000 - 105,000; Full time

Job summary

National Council on Alcoholism in Los Angeles is seeking a Quality Assurance Specialist to support the integrity and accuracy of Drug Medi-Cal services. The role ensures documentation supports reimbursement, regulatory compliance, and medical necessity across SAPC, DHCS, Medi-Cal, CalAIM, and organizational standards.

The position requires hands-on experience with DMC billing workflows and Sage-PCNX, with collaboration across clinical leadership, LPHA staff, Finance, and operations to strengthen

Qualifications

• Hands-on experience with DMC billing and documentation workflows.
• Ability to review clinical documentation for accuracy and compliance.
• Collaborates with clinical and administrative staff to correct issues.
• Familiarity with SAPC, DHCS, Medi-Cal and CalAIM requirements.

Responsibilities

• Perform pre-billing reviews to ensure services are supported by documentation.
• Verify service dates, types, duration, units, locations, and rendering providers.
• Identify billing discrepancies such as duplicates, missing docs, or incorrect codes.
• Coordinate corrections with staff and track resolution of issues.
• Conduct internal chart reviews, audits, and quality improvement activities.
• Support audits and responses to audit findings and corrective actions.

Skills

Quality Assurance

DMC billing knowledge

Documentation review

Tools

Sage-PCNX

EHR systems

Job description

National Council on Alcoholism in Los Angeles is seeking a Quality Assurance Specialist to support the integrity and accuracy of Drug Medi-Cal services. The role ensures documentation supports reimbursement, regulatory compliance, and medical necessity across SAPC, DHCS, Medi-Cal, CalAIM, and organizational standards.

The position requires hands-on experience with DMC billing workflows and Sage-PCNX, with collaboration across clinical leadership, LPHA staff, Finance, and operations to strengthen