Medical Billing Specialist I​/II

Position Description

Medical Billing Specialist I - $23.39-$28.76

Medical Billing Specialist II - $25.79-$31.70

Join a Team That Makes Every Dollar Count for the People We Serve Behind every successful behavioral health program is a strong team ensuring services are accurately documented, billed, and reimbursed so care can continue. At Calaveras County Behavioral Health, our Medical Billing Specialists play a vital role in supporting access to mental health and substance use disorder treatment by helping maximize reimbursement, maintain compliance, and protect the financial resources that allow our programs to grow.

As California's behavioral health system continues to transform through CalAIM, the Behavioral Health Services Act (BHSA), Enhanced Care Management (ECM), Community Supports (CS), Justice Involved services, BH-CONNECT, and expanded housing initiatives, our billing professionals have become more important than ever. This position goes far beyond traditional medical billing—you will work closely with clinicians, fiscal staff, managed care plans, hospitals, and community partners to ensure accurate claims, resolve billing issues, reconcile payments, and support the financial sustainability of services that change lives.

We're looking for someone who enjoys solving problems, pays close attention to detail, thrives in a collaborative environment, and takes pride in knowing that their work directly supports individuals and families throughout Calaveras County. At Calaveras County Behavioral Health, we believe every role contributes to our mission of helping people live healthier, more independent, and more hopeful lives. If you're looking for meaningful work where your knowledge, initiative, and dedication truly make a difference, we'd love to have you join our team.

Under general direction, to perform specialized clerical work in connection with processing and billing fiscal intermediaries for medical services rendered to patients; and to do other work as required for Behavioral Health Services.

This is an entry-level classification in the Medical Billing Specialist series; incumbents will be expected to perform more routine duties while gaining additional experience and familiarity with departmental policies and procedures. This position is responsible for working with medical billing documents, reviewing and verifying insurance accounts against third party billing program provision and procedures. Incumbents in this class are expected to solve routine problems without assistance while unusual problems are referred to a supervisor.

This is the Journey-level classification in the Medical Billing Specialist series;
Incumbents will be expected to perform more technical duties related to medical billing functions. This position is responsible for working with medical billing documents, reviewing and verifying insurance accounts against third party billing program provision and procedures; interpreting policies, rules, or regulations on billing related matters and/or assisting in the coordination of procedures among various patient accounts systems. Incumbents in this class are expected to solve routine as well as highly complex problems without assistance.

• Check and correct bills and accounts for numerical accuracy and proper coding, and prepare paperwork for data entry.
• Input service claims into Electronic Health Record billing system.
• Verify billing account or insurance forms for completeness and accuracy against a variety of automated and manual records.
• Review patient accounts to determine the accuracy of account information and make any required adjustments for proper billing purposes.
• Review monthly paid, denied and rejected claims for Medi-Cal and third party insurance companies.
• Process denied claims through Electronic Rebill System if applicable for reimbursement.
• Prepare self-pay bills; close charges for pay client accounts; review bills for accuracy.
• Post payments received from various funding sources.
• Process explanation of benefits when additional…