Billing Analyst

🕒 July 7

🏄 California – Remote

🏄 California – Remote

💵 $49.9k - $54.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Billing Specialist

👻 Ghost score 42%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Pacific Health Group

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2023

🏥 Healthcare

🧘 Wellness

🌍 Social Impact

Healthcare • Wellness • Social Impact

Pacific Health Group is a community-focused healthcare organization that delivers integrated medical, behavioral health, and social support services to improve the wellbeing of underserved populations. The organization provides enhanced care management for complex needs, behavioral health and substance-use treatment, community health worker outreach, street medicine for people experiencing homelessness, community support services (including housing assistance), and non-ambulatory medical transportation. Pacific Health Group partners with health plans and centers care on whole-person wellness, equity, and access across multiple locations.

📋 Description

• Own the end-to-end revenue cycle for Clubhouse Services claims under San Diego County's BH-CONNECT Clubhouse Services benefit • Prepare, scrub, and submit daily bundled-rate claims through the County of San Diego's claiming system/EHR and ShortDoyle/MediCal process • Apply correct procedure codes, modifiers, place-of-service, and provider data according to BHIN 25009, the BH-CONNECT EBP Policy Guide, and County billing manuals • Reconcile attendance logs and service documentation against claimable member days • Track timely filing requirements and County claim submission calendars • Verify MediCal eligibility and aid codes monthly and before claiming • Coordinate resolution of eligibility discrepancies with program staff and County BHS • Work denials, disallowances, and voids/replacements; perform root-cause analysis and correct/resubmit claims • Reconcile 835s/EOBs against submitted claims and maintain accounts receivable aging • Prepare monthly revenue reconciliation reports for leadership • Monitor DHCS BHINs and County BHS updates for claiming changes • Track accreditation-linked billing status and support internal charter-claim audits • Respond to County/DHCS audit requests, recoupments, and cost report or data submissions • Ensure billing complies with HIPAA, 42 CFR Part 2 where applicable, and MediCal program integrity requirements • Serve as billing liaison to County of San Diego BHS billing/fiscal contacts • Train Clubhouse program staff on documentation requirements • Assist with billing workflow buildout, desk procedures, and QA processes for the new service line • Support billing for other Pacific Health Group lines of business as capacity allows

🎯 Requirements

• 3+ years of medical billing experience, with at least 1 year in behavioral health, MediCal, or county Specialty Mental Health Services (SMHS) billing • Working knowledge of MediCal eligibility verification, aid codes, and claim adjudication (837/835 transactions, denial codes, void/replace processes) • Experience with an EHR/practice management system used for behavioral health claims (e.g., SmartCare, Cerner/CCBH, Netsmart, or comparable) • Strong Excel skills (pivot tables, VLOOKUP/XLOOKUP or equivalent) for reconciliation and reporting • High attention to detail, documentation discipline, and ability to work independently in a program with new and evolving guidance • High school diploma or GED required • Direct experience billing County of San Diego BHS / ShortDoyle MediCal preferred • Familiarity with CalAIM, BHCONNECT, per diem or bundled rate reimbursement models, or psychosocial rehabilitation programs preferred • Certified Professional Biller (CPB), CRCR, or equivalent credential preferred • Experience standing up billing operations for a new program or contract preferred • Bilingual English/Spanish preferred • Must work Monday–Friday, 8:30 am–5 pm • Must be based in California

🏖️ Benefits

• 160 Hours of Paid Time Off (PTO) • 12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment • 4 Paid Volunteer Hours per Month • Bereavement Leave, including Fur Baby Bereavement • 90% Employer-paid Employee-Only Medical Benefits • Dental and Vision Insurance • FSA | Dependent Care Account • 401(k) with Company Match • Monthly Stipend • Short-Term & Long-Term Disability | AD&D • Employee Assistance Program (EAP) • Employee Discounts via Great Work Perks and Perks at Work • Quarterly In-Person Events • Fully remote work within California • Opportunities for professional development and internal growth