Cal AIM Revenue Cycle Biller

Job Title: CalAIM Revenue Cycle Biller 

About JFS of Silicon Valley 

JFS SV envisions a world where each person achieves self-sufficiency, stability, well-being, and purpose. JFS SV is an inclusive nonprofit social services organization providing comprehensive support services to individuals and families facing life challenges. We engage community partners and collectively we make a positive impact on the lives of those we serve. As an inclusive organization, our biggest strengths are the unwavering support we provide to all employees and the celebration of diversity amongst all communities. 

Position Summary 

The CalAIM Revenue Cycle Biller is responsible for coordinating billing, data submission, and reimbursement processes for California Advancing and Innovating Medi-Cal (CalAIM) services, with a focus on Enhanced Care Management (ECM) and Community Supports (CS) programs.  

This role works closely with contracted Managed Care Plans (health plans) that process claims on behalf of the organization. The position ensures accurate service data submission, timely payment reconciliation, and compliance with Medi-Cal and payer requirements, while supporting overall revenue integrity and audit readiness. 

Key Responsibilities 

Billing Coordination & Data Submission  

• Prepare and submit encounter data, invoices, and service files to Managed Care Plans (MCPs)  
• Coordinate with health plans to ensure timely and accurate processing of claims  
• Ensure all submissions comply with CalAIM requirements, payer contracts, and documentation standards  
• Track submission timelines and resolve discrepancies with health plan billing teams  

Payment Monitoring & Reconciliation  

• Review remittance advices and payment reports from MCPs  
• Reconcile payments against submitted services, authorizations, and contracted rates  
• Investigate and follow up on missing payments, denials, or rate variances  
• Maintain internal tracking logs and supporting documentation for all billed services  

Cal AIM Program Support  

• Apply CalAIM billing rules for Enhanced Care Management and Community Supports services  
• Collaborate with program and care management teams to ensure services are properly documented and billable  
• Track utilization, authorizations, and service units to support accurate billing  

Revenue Cycle & Reporting  

• Perform monthly revenue reconciliation and variance analysis  
• Support Accounts Receivable tracking aligned with health plan payment cycles  
• Prepare billing and revenue reports for finance and program leadership  
• Assist with forecasting related to ECM and CS funding  

Compliance & Audit Readiness  

• Ensure billing processes align with DHCS, Medi-Cal, and MCP requirements  
• Maintain organized documentation to support internal and external audits  
• Assist with audit requests and respond to payer inquiries as needed 

Qualifications 

Education 

• Bachelor’s degree in accounting, finance, economics, or a related field. 

Experience 

• 2 - 5 years of healthcare billing or revenue cycle experience  
• Experience with Medi-Cal, Medicaid, or managed care environments  
• Familiarity with payer reconciliation and health plan processes  
• Proficiency in Excel, billing systems, and/or EHR platforms 
• Extensive experience with Office Ally setup and navigation 

Skills & Competencies 

• Proficiency with accounting and financial management systems. 
• Familiarity with grant compliance, contract billing, or multi‑payer revenue environments. 
• Working knowledge of GAAP and nonprofit accounting principles. 
• Exceptional attention to detail with a strong compliance and audit mindset. 
• Ability to communicate effectively with financial and non‑financial stakeholders. 
• Strong organizational and time‑management skills with the ability to manage multiple deadlines. 
• Proactive, collaborative problem‑solver with a continuous‑improvement orientation. 

Salary and Benefits:  

Salary Range: $60,000 - $75,000   annually. Full-Time, Monday to Friday.  

This position is full-time, 37.5 hours/week. The salary is commensurate with the selected candidate's qualifications and experience.  

Benefits include medical, dental, and vision care; company contributions to 403(b) retirement plan; generous paid time off; supportive colleagues; and a positive work environment in a spacious office setting.  

JFS of Silicon Valley is an equal-opportunity employer that values diversity at all organizational levels. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.