Cal AIM Data Specialist

Cal Aim Data Specialist

Are you a passionate and motivated individual eager to make a positive impact in the community? Hope Cooperative is a well-respected, award-winning nonprofit organization that provides comprehensive mental health and supportive housing services across Sacramento County. We're seeking compassionate, dedicated individuals to join our team and support the most vulnerable in our community.

Position Title: Cal Aim Data Specialist

Program(s) and Location: Cal Aim (Sacramento, CA) Schedule: Full-time, Non-Exempt, 40 hours per week, Monday through Friday 8am to 4:30pm Pay Rate: $24.15 - $26.12 hourly

About the Position:

The CalAIM Data Specialist, reporting to the CalAIM Program Manager, ensures accuracy, compliance, and efficiency of CalAIM service delivery. This role supports the revenue cycle by reviewing authorizations and claims, identifying errors, monitoring billing trends, and ensuring adherence to payer rules, coding guidelines, and internal standards. The ideal candidate is detail-oriented, highly organized, and experienced in behavioral health billing practices.

Essential Duties & Responsibilities:

• Verify correct entry into the EHR systems utilized by CalAIM (Salesforce and HMIS), ensure completeness of EHR forms, prepare and submit any EHR claims correction spreadsheets to the EHR liaison for submission to partnering care plans.
• Build new client profiles within SalesForce upon receipt of referrals ensuring accuracy and entry of required information
• Maintain authorization status through the duration of services provided
• Maintain census data for services provided within residential sites
• Check and update monthly Medi-Cal eligibility for all CalAim clients.
• Work with billing entities including consultants to ensure accuracy of billing claims
• Act as liaison to partnering care plans attending meetings, consultations, and trainings as needed
• Accurately complete all necessary forms, reports and paperwork required by the program on a timely basis.
• Conduct service report reviews across program to ensure accuracy and compliance
• Ensuring billing accuracy and making necessary corrections.
• Coordinate, or assist in, projects as directed, including creating, preparing and distributing special reports as needed or assigned.
• Act as a designated Mandated Reporter for the observed or suspected abuse and/or neglect of children, disabled individuals, dependent adults and elder/senior citizens. Mandated Reporter also includes "Duty to Warn" which includes the responsibility to notify authorities and the intended victim(s) of physical harm.
• Ensure the protection and confidentiality of all Protected Health Information (PHI) by following all policies and procedures in the HIPAA Manual.
• Regular and predictable attendance required.
• Use motivational interviewing, trauma-informed care, and harm-reduction practices

Qualifications:

• High School diploma or equivalent
• Demonstrated experience with Medi-Cal billing and EHR System.
• Two (2) years of office work experience with attention to details.

Other Skills, Abilities, and Job Requirements:

• Ability to pass clearance of the Federal Bureau of Investigation (FBI) and/or Department of Justice (DOJ) background screenings
• Consumer of mental health services or a family member of a mental health consumer is desirable

Benefits:

HOPE Cooperative (also known as TLCS, Inc.) provides a competitive benefits package, which includes, but is not limited to, the following items. Please note that benefits may be subject to change:

• 21 PTO days per year (4 weeks & 1 day)
• 26 PTO days after the 5th year (5 weeks & 1 day)
• 6 days paid sick time
• 11 paid holidays
• 1 Personal Day
• Leadership Development
• Reimbursements
• Eligible for Government Loan Forgiveness Programs
• Employer-paid health insurance for employees and children (Kaiser, Sutter or Western Health Advantage)
• HSA Contributions
• Flexible Spending Account
• 401k match
• PTO Cash Out
• Voluntary Dental, Vision, Life Insurance, Accident Insurance, Disability Insurance and more
• Employee Assistance Program
• Regular wage step scale increases
• Flexible start/end times for some positions
• iPhone with unlimited data for personal/professional use and laptop for some positions
• Clinical Supervision towards licensure (for certain positions and upon approval)
• CEU days for certain positions
• Up to $500 CEU allowance for certain positions
• Annual BBQ and staff appreciation awards
• Annual Gift Card Program
• Referral Bonuses

All benefit offerings are subject to change and are governed by the eligibility guidelines in the Employee Handbook. This list represents a general summary of available benefits and nothing stated here should be interpreted as being included in a written offer for employment.

HOPE Cooperative (aka TLCS, Inc.) is an Affirmative Action/Equal Opportunity Employer, and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state or local protected class. Our agency embraces a diverse & culturally rich workforce, and we welcome all candidates to apply.