Medi-Cal RCM Consultant: Denials & Dashboards

Vayu Health; San Francisco (CA); Hybrid; USD 48,000 - 72,000; Full time

Job summary

Vayu Health in San Francisco seeks an analytical Revenue Cycle Management consultant for a targeted contract engagement. You will audit, clean up, and optimize our medical billing operations between clinical teams and our platform partner Sprite Health.

You will handle claims reconciliation, denial resolution, RA alignment, and manual tracking where automation lags, collaborating with Sprite Health to ensure accurate revenue reporting and dashboard updates for our finance team.

Qualifications

• Deep knowledge of California Medi-Cal billing frameworks with ECM/ECM+ experience.
• Proven ability to identify root causes for $0 payments, missing claims and payer denials.
• Experience navigating California Managed Care Plan portals (Partnership HealthPlan of CA and Health Net).
• Experience with RCM/EHR systems and evolving dashboards.

Responsibilities

• Audit and reconcile monthly clinical encounter logs against submitted claims.
• Investigate backlog of $0-paid and denied claims and file Provider Dispute Resolutions (PDRs).
• Post electronic and paper ERAs/EOBs into RCM platform and ensure dashboard reflects actual revenue.
• Maintain independent claims-tracking log when automation lags and reconcile with payer portals.

Skills

Medi-Cal billing

Claims auditing

Payer portals

RCM/EHR systems

Excel mastery

Data analysis

Communication

Tools

EHR dashboards

Job description

Vayu Health in San Francisco seeks an analytical Revenue Cycle Management consultant for a targeted contract engagement. You will audit, clean up, and optimize our medical billing operations between clinical teams and our platform partner Sprite Health.

You will handle claims reconciliation, denial resolution, RA alignment, and manual tracking where automation lags, collaborating with Sprite Health to ensure accurate revenue reporting and dashboard updates for our finance team.