3 jobs found in Stockton

Calaim Medical Billing Specialist The CalAIM Medical Billing Specialist is responsible for managing the day-to-day administrative and billing operations related to Enhanced Care Management (ECM) and Community Supports (CS) services. This position supports the organization's CalAIM programming by ensuring accurate claims submission, authorization management, billing compliance, encounter tracking, and reimbursement optimization in accordance with DHCS, Managed Care Plan (MCP), Medi-Cal, and organizational requirements. The Billing Specialist works closely with care managers, housing support staff, leadership, and Managed Care Plans to ensure timely and compliant billing processes while maintaining accurate records within electronic medical records (EMR/EHR) and billing systems. ***This is not a remote position*** Qualifications High school diploma or equivalent required; Associate's degree in Medical Billing and Coding, Healthcare Administration, Business Administration,...

Hospice of San Joaquin is the oldest not-for-profit hospice of over 45 years.  We serve all of San Joaquin and Stanislaus Counties.  We are committed to continuing to be the leader in ensuring the quality of the journey, from a serious illness through the end of life, and to honor our mission by honoring life by ensuring patients and their Caregivers are the focus of everything we do.  We are seeking a Dynamic, self-motivated Billing Compliance Auditor who thrives in a fast-paced environment and supports our mission.   POSITION SUMMARY The Billing Auditor is responsible for auditing hospice claims, clinical documentation, and billing workflows to confirm that services billed to Medicare, Medi-Cal, and commercial payers are supported by the medical record and meet all regulatory requirements. The position bridges the clinical and financial sides of hospice operations. The auditor must read clinical documentation with enough depth to judge eligibility and level of care support,...

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses. Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements. Review and verify accuracy of billing data within...