Billing Specialist

About Lao Family Community Development, Inc.

Lao Family Community Development, Inc. (LFCD) is a community-based non-profit organization established in Richmond, Contra Costa County, California, in 1980. Since then, LFCD has expanded its operations to Alameda and Sacramento counties with its headquarters located in Oakland, California. LFCD delivers programs and services from seven locations in more than 35 languages. The organization provides community development, affordable real estate, workforce development, education, and human services that primarily support low-income individuals and families, refugees, immigrants, transitional-age youth, seniors, individuals with disabilities, and other underserved populations.

Job Summary

Under the Program Manager's direction, the CalAIM Billing Specialist manages day-to-day billing activities for LFCD's Enhanced Care Management (ECM) and Community Supports (CS) services across contracted health plans. This position will manage the billing process from claim preparation and submission through payment, rejection/denial review, correction, resubmission, and follow-up. The Billing Specialist will work closely with the CalAIM Program Manager, care management staff, and other internal teams to ensure services are accurately documented, billed timely, and reimbursed appropriately. The ideal candidate is detail-oriented, organized, able to identify and resolve billing issues independently, and comfortable working with multiple health plans that may have different billing requirements and processes. Reports to the Program Manager and will be stationed in the South Sacramento Office.

Roles and Responsibilities

• Create and submit new claims/bills for all CalAIM services according to each health plan’s requirements.
• Monitor submitted claims and track paid, pending, denied, rejected, outstandading balances, returned claims, and any outstanding issues.
• Review rejected or denied claims to determine why the claim was not accepted or paid.
• Correct billing errors, obtain missing information, and resubmit claims when appropriate.
• Follow up with health plans when claims remain pending or require additional information.
• Maintain an organized billing tracking system for all health plans.
• Monitor outstanding/aged claims and proactively follow up rather than waiting for problems to be identified.
• Identify recurring billing issues or trends and bring them to the supervisor's attention.
• Maintain accurate billing documentation and records for audit and compliance purposes.
• Prepare regular billing reports.
• Escalate issues when they require management decisions, contract interpretation, health-plan intervention, or other higher-level support.
• Communicate with Lead Care Managers, Care Managers, Program Specialists, and other staff when you need additional information or documentation for billing.
• Help program staff understand billing-related documentation requirements when needed.
• Maintain professional and timely communication with internal staff regarding billing questions and issues.
• Perform other duties and special projects as assigned.

Qualifications and Strongly Preferred Experiences

• High School Diploma required; an Associate's or Bachelor’s degree in accounting, business administration, finance, or marketing preferred.
• Certification programs in bookkeeping, billing, office administration, or data entry will be considered.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint), database management systems, electronic case management systems, and internet browsers, including Chrome, Edge, and Safari.
• Strong basic math skills, attention to detail, and accurate data entry skills
• Organization and time management skills
• Self-motivated with the ability to work independently with minimal supervision while effectively managing multiple priorities and deadlines.
• Excellent verbal and written communication, community relations, networking, presentation, and public speaking skills.
• Demonstrated ability to work effectively and respectfully with individuals and families from diverse cultural, racial, ethnic, socioeconomic, religious, gender, age, disability, and sexual orientation backgrounds.
• In compliance with federal law, all persons hired must verify identity and eligibility to work in the United States and complete the required employment eligibility verification form upon hire; a background check is required.
• Must successfully pass all required background checks and meet applicable program, funding source, and agency requirements.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit and work on the computer; use hands to handle or feel and talk or hear; and move objects up to 25 pounds.

Compensation

Salary based on experience and education, along with a comprehensive benefits package including health plan/vision, dental, paid vacations, holidays, sick leave, and employer-contributed pension/group life insurance.

To Apply

Please submit your cover letter and resume. This position is open until filled and may be closed at any time.

Equal Employment Opportunity

Lao Family Community Development Inc. (LFCD) is an equal opportunity employer and program operator. LFCD provides equal employment opportunities to all employees and applicants and prohibits unlawful discrimination, harassment, and retaliation based on race (including traits historically associated with race, such as hair texture and protective hairstyles), color, religion (including religious dress and grooming practices), creed, national origin, ancestry, citizenship or immigration status as protected by law, age (40 and over), sex, pregnancy, childbirth, breastfeeding and related medical conditions, gender, gender identity, gender expression, sexual orientation, reproductive health decision-making, marital status, registered domestic partner status, medical condition, genetic information, physical or mental disability, military or veteran status, or any other characteristic protected by applicable federal, state, or local law. LFCD also complies with applicable disability-access and reasonable-accommodation requirements, including the Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12101 et seq. , the California Fair Employment and Housing Act (FEHA), and other applicable federal, state, and local laws.