Top 94 Eligibility specialist 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
PACE Enrollment Specialist (Central Valley PACE - Stockton)
Golden Valley Health Centers —Stockton, CA
- $25.22 - $26.48 an hour
- Call employer
- Spanish
- CPR Certification
- Clean driving record
- 403(b) matching
- Dental insurance
Quick Apply
Behavioral Health Specialist I
Turning Point Community Programs —Stockton, CA
- $24.00 - $25.98 an hour
- On call
- Skilled nursing facility
- High school diploma or GED
- Driver's License
Quick Apply
Visitation Coach Specialist, San Joaquin Supervised Visitation
Wayfinder Family Services —Stockton, CA
- $19 - $21 an hour
- Part-time
- Office
- High school diploma or GED
- Driver's License
- 401(k) matching
- Loan forgiveness
Quick Apply
Work Program Specialist I
San Joaquin County —French Camp, CA
- $3,800.20 - $4,619.17 a month
- Overtime
- Basic math
- Pass drug screening
- Children
- Paid holidays
- Health insurance
8d
Medical Billing Specialist
San Joaquin Kidney Clinic —Stockton, CA
- From $17 an hour
- Full-time
- Research
- Office
- In-person
- Health insurance
- Paid time off
Quick Apply
20h
Member Engagement Specialist
Pacific Health Group —Stockton, CA
- $45,760 - $52,000 a year
- Full-time
- Hybrid work
- Spanish
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Behavioral Health Specialist II
Turning Point Community Programs —French Camp, CA
- $25 an hour
- Skilled nursing facility
- Adults
- Mid-level
Quick Apply
7d
College Advising Mentor Specialist
IMPROVE YOUR TOMORROW —Stockton, CA
- $26.00 - $35.57 an hour
- Weekends as needed
- Spanish
- Google Workspace
- Computer literacy
- 403(b) matching
- AD&D insurance
Billing Specialist
Maxim Crane Works LP —Stockton, CA
- Writing skills
- Mid-level
- Office
- Paid parental leave
- Health savings account
Quick Apply
Mental Health Specialist I- Part time
San Joaquin County —San Joaquin County, CA
- $27.78 - $33.76 an hour
- Part-time
- Nursing
- Addiction Medicine
- Pass drug screening
3d
Bilingual Case Management Specialist (Remote Flexible, Spanish Speaking)
Pair Team —Stockton, CA
- $22 - $25 an hour
- Email
- Background check
- Spanish
- HIPAA
- Dental insurance
- 401(k)
Quick Apply
11d
Food Safety Specialist
Kevin's Natural Foods —Stockton, CA
- $75,000 - $85,000 a year
- Full-time
- Spanish
- English
- Mid-level
Quick Apply
Benefit Configuration Specialist
Wipro Limited —Atlanta, CA
- $37,500 - $83,600 a year
- Pass drug screening
- Mid-level
- 2 years
- Disability insurance
- Health insurance
3d
Public Information Specialist
San Joaquin County —French Camp, CA
- $6,757.34 - $8,213.59 a month
- Weekends as needed
- Computer literacy
- Pass drug screening
- Public speaking
- Paid holidays
- Health insurance
8d
Family Services Specialist
Community Action Partnership of San Luis Obispo —French Camp, CA
- $19.20 - $22.75 an hour
- Seasonal
- Bilingual
- Bachelor of Science
- Driver's License
Quick Apply
Field Hospital Enrollment Specialist (Bilingual Spanish)
Pair Team —Tracy, CA
- $28 - $30 an hour
- Email
- Background check
- Spanish
- Google Workspace
- Dental insurance
- 401(k)
Quick Apply
5d
Sr Procurement Specialist
San Joaquin Delta College —Stockton, CA
- $6,463 - $7,945 a month
- Full-time
- Writing skills
- Basic math
- Research
- Disability insurance
- Health insurance
7d
Senior Financial Aid Specialist
San Joaquin Delta College —Stockton, CA
- $5,854 - $7,195 a month
- Full-time
- 5 years
- Writing skills
- Office
- Disability insurance
- Health insurance
Recruitment Specialist
IMPROVE YOUR TOMORROW —Stockton, CA
- $1,381.30 - $2,550.00 a week
- Seasonal
- Spanish
- Mid-level
- High school diploma or GED
- Mileage reimbursement

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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

eligibility specialist jobs in stockton ca

CalAIM Medical Billing Specialist

PACE Enrollment Specialist (Central Valley PACE - Stockton)

Behavioral Health Specialist I

Visitation Coach Specialist, San Joaquin Supervised Visitation

Work Program Specialist I

Medical Billing Specialist

Member Engagement Specialist

Behavioral Health Specialist II

College Advising Mentor Specialist

Billing Specialist

Mental Health Specialist I- Part time

Bilingual Case Management Specialist (Remote Flexible, Spanish Speaking)

Food Safety Specialist

Benefit Configuration Specialist

Public Information Specialist

Family Services Specialist

Field Hospital Enrollment Specialist (Bilingual Spanish)

Sr Procurement Specialist

Senior Financial Aid Specialist

Recruitment Specialist

I want to receive the latest job alert for eligibility specialist in stockton ca

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