Top 462 Member services representative Jobs in Stockton, Ca

CalAIM Medical Billing Specialist
Friends Outside —Stockton, CA
- From $28 an hour
- Full-time
- No background check
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Member Services Representative
Planet Fitness —Stockton, CA
- $17 - $19 an hour
- Computer literacy
- Cash register
- Computer skills
Quick Apply
Member Services Representative
Crunch Stockton —Stockton, CA
- Full-time
- Computer literacy
- Writing skills
- English
Quick Apply
On-Site Service Representative Part-Time 30 Lodi & Elk Grove CA Route
W.W. Grainger —Lodi, CA
- $23 - $29 an hour
- Part-time
- 3 years
- High school diploma or GED
- Driver's License
- Paid parental leave
- Dental insurance
Customer Service Representative - State Farm Agent Team Member
David Nugent - State Farm Agent —Lodi, CA
- $62,000 - $93,000 a year
- Full-time
- Sales
- Office
- Communication skills
- Paid time off
- 401(k) matching
Quick Apply
Team Member
Jamba —Stockton, CA
- Overtime
- Serving
- No education required
- 16+ years old
Quick Apply
Social Services Assistant
4545 Shelley Court Opco LLC —Stockton, CA
- $21 - $23 an hour
- Weekends as needed
- Pre-employment physical examination
- Entry level
Quick Apply
Track Maintenance - Laborer - Stockton, CA
BNSF Railway —Stockton, CA
- $37.66 an hour
- Overtime
- 18 years or older
- Construction site
- Pass drug screening
- Travel reimbursement
- Health insurance
2d
ADMISSIONS COORDINATOR
O'Connor Woods —Stockton, CA
- $33 - $35 an hour
- Skilled nursing facility
- Mid-level
- Computer skills
Quick Apply
JD Associate - Weberstown Mall, Stockton, CA
Finish Line —Stockton, CA
- $16.90 an hour
- Part-time
- 18 years or older
- Merchandising
- Maintenance
- 401(k)
- Employee discount
Cashier 2pm-10pm
3 B'S TRUCK AND AUTO PLAZA —Lodi, CA
- $17.00 - $22.50 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Merchandising
- Flexible schedule
Quick Apply
Parent Partner
Aspiranet —Stockton, CA
- $22.00 - $22.50 an hour
- Online Application
- Clean driving record
- Writing skills
- English
- 403(b) matching
- Paid holidays
Quick Apply
14d
CSR - Customer Service Representative
ARCO/AMPM (Adelfos INC) —Stockton, CA
- From $17 an hour
- 8 hour shift
- Merchandising
- Cooking
- No experience needed
Quick Apply
14d
DC Materials Handler - Returns
O'Reilly Automotive Stores —Stockton, CA
- $22.05 - $25.55 an hour
- Computer literacy
- High school diploma or GED
- Warehouse experience
- Employee stock purchase plan
- Health insurance
Quick Apply
Cashier- Stockton
Andre-Boudin Bakeries —Stockton, CA
- $16.90 - $17.00 an hour
- Customer service
- Cash register
- Bakery
- Flexible schedule
Quick Apply
Restaurant Crewmember
Raising Cane's —Manteca, CA
- From $20 an hour
- Urgently hiring
- No experience needed
- Ability to climb stairs
- Ability to lift 50 pounds
- Paid training
- Disability insurance
Quick Apply
Credit Analyst
BAC Community Bank —Stockton, CA
- $47,000 - $60,000 a year
- Full-time
- Microsoft Outlook
- Customer service
- English
- Health insurance
- Dental insurance
Quick Apply
SCE Planning Project Manager
SummitWest Environmental —California
- $85,000 - $115,000 a year
- Full-time
- Remote
- Background check
- Management
- 5 years
- Paid training
- Health insurance
Quick Apply
Teacher
Child Abuse Prevention Council (CAPC) —Stockton, CA
- $21.43 - $25.81 an hour
- Full-time
- Background check
- Classroom
- Serving
- Health insurance
- Dental insurance
Quick Apply
Community Base Supervisor ( LMFT, LCSW, LPCC)
Mountain Valley Child and Family Services —Brentwood, CA
- $80,000 - $88,000 a year
- Full-time
- LMFT
- Current TB test
- Ability to walk for extended periods
- Health insurance
- Dental insurance
Quick Apply

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CalAIM Medical Billing Specialist

Friends Outside
Stockton, CA

Quick Apply

Job Details

Full-time
From $28 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Life insurance

Qualifications

Regulatory compliance in claims processing
HIPAA
High school diploma or GED
Electronic health record (EHR) management for billing and coding
Health information regulatory compliance
Organizational skills
Business Administration
Clinical confidentiality policies
Business
Associate's degree

Full Job Description

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, or related field preferred
Minimum of two years of medical billing experience, preferably within Medi-Cal, managed care, behavioral health, or community-based services
Knowledge of CalAIM, Enhanced Care Management (ECM), Community Supports (CS), and Medi-Cal billing practices preferred
Experience with electronic medical record (EMR/EHR) and billing software systems
Understanding of HIPAA regulations, healthcare documentation standards, and claims processing workflows
Strong attention to detail, organizational skills, and ability to manage multiple priorities
Excellent communication and problem-solving abilities

Key Responsibilities

Billing & Claims Management

Submit invoices and claims to Managed Care Plans (MCPs) for ECM and Community Supports services rendered to authorized members
Prepare and submit clean claims electronically or by paper in accordance with payer guidelines, DHCS standards, and MCP requirements
Submit claims utilizing national standard specifications, billing codes, and code sets established by DHCS for ECM and Community Supports services
Ensure maximum reimbursement through accurate billing, coding, and documentation review
Review claims for accuracy, completeness, and compliance prior to submission
Monitor claim status and assigned billing queues daily to support timely payment processing
Manage claims follow-up, denial management, corrections, appeals, and resubmissions as needed
Process and reconcile payer responses, payment postings, and billing reports

Authorization & Eligibility Oversight

Verify member eligibility with assigned MCPs prior to billing and throughout service enrollment periods
Monitor and maintain ECM and Community Supports authorizations, referrals, and service approvals
Ensure services billed are authorized, medically appropriate, and documented in accordance with DHCS and MCP requirements
Track authorization expiration dates and coordinate reauthorization needs with program staff

Documentation & Compliance

Maintain accurate and up-to-date data in electronic medical record (EMR/EHR) systems and billing platforms
Ensure documentation supports billed services and complies with ECM and Community Supports standards, including encounter documentation requirements
Maintain strict confidentiality of protected health information in compliance with HIPAA and organizational policies
Support compliance with consent, authorization, and data-sharing requirements related to CalAIM services
Assist with audits, monitoring activities, and reporting requests related to billing and claims processing

Coordination & Communication

Coordinate with care managers, housing support staff, supervisors, and external partners to obtain necessary documentation and service information
Communicate with MCP representatives regarding claims, authorizations, billing inquiries, and service requirements
Assist staff in resolving documentation deficiencies impacting billing or reimbursement
Participate in interdisciplinary meetings as needed to support program operations and billing integrity

Training & Quality Improvement

Attend required trainings and maintain current knowledge of CalAIM, ECM, Community Supports, DHCS, and MCP billing requirements
Stay informed on policy, coding, and compliance updates impacting billing practices
Contribute to process improvement efforts to enhance billing accuracy, compliance, and reimbursement outcomes

Pay: From $28.00 per hour

Benefits:

401(k)
Dental insurance
Employee assistance program
Health insurance
Life insurance
Paid time off
Vision insurance

People with a criminal record are encouraged to apply

Application Question(s):

Do you have knowledge of CalAIM, Enhanced Care Management (ECM), Community Supports (CS), and Medi-Cal billing practices?
Do you have experience with electronic medical record (EMR/EHR) and billing software systems?
Do you have a minimum of two years of medical billing experience, preferably within Medi-Cal, managed care, behavioral health, or community-based services?

Work Location: In person

Quick Apply

Refine Your Search

member services representative jobs in stockton, ca

CalAIM Medical Billing Specialist

Member Services Representative

Member Services Representative

On-Site Service Representative Part-Time 30 Lodi & Elk Grove CA Route

Customer Service Representative - State Farm Agent Team Member

Team Member

Social Services Assistant

Track Maintenance - Laborer - Stockton, CA

ADMISSIONS COORDINATOR

JD Associate - Weberstown Mall, Stockton, CA

Cashier 2pm-10pm

Parent Partner

CSR - Customer Service Representative

DC Materials Handler - Returns

Cashier- Stockton

Restaurant Crewmember

Credit Analyst

SCE Planning Project Manager

Teacher

Community Base Supervisor ( LMFT, LCSW, LPCC)

I want to receive the latest job alert for member services representative in stockton, ca

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