[Remote] Medi-Cal Billing Infrastructure Consultant

Note: The job is a remote job and is open to candidates in USA. Compass Family Services is a nonprofit organization dedicated to assisting San Francisco families who are homeless or at-risk of homelessness. They are seeking a Medi-Cal Billing Infrastructure Consultant to guide the development of their billing infrastructure for behavioral health services, ensuring compliance and optimizing revenue opportunities.ResponsibilitiesConduct a series of analyses and produce key deliverables, including service billing feasibility, billing pathway comparison, and EHR system recommendationsAssess the Medi-Cal eligibility rate among current CBHS clients and map CBHS services to billable Medi-Cal benefit categoriesProduce a revenue model with low, mid, and high scenarios that validates or revises internal projections of billing revenueIdentify which CBHS services are billable under standard outpatient Medi-Cal codes and advise on handling non-billable servicesAssess the financial, administrative, and logistical considerations involved in billing through a third-party entity as compared to billing Medi-Cal directlyAdvise on EHR requirements from a Medi-Cal billing and compliance standpointReview findings from the internal readiness audit and advise on critical gaps to address before billing beginsParticipate in contract negotiation with a third-party billing partner and advise on considerations for billing setupAdvise on denial pattern analysis, documentation improvement, and workflow optimization as billing beginsSupport development of billing compliance policies, utilization review processes, audit readiness procedures, and privacy protocols to Medi-Cal standardsProvide direct support in preparing and submitting the certification application to the county MHP or applicable health systemAdvise on how to integrate the internal Salesforce database with a new EHRAssist in preparing and administering staff trainingSkillsDeep working knowledge of the California Medi-Cal behavioral health systemExperience with community-based nonprofit providersAbility to work practically and collaboratively with an internal team new to Medi-CalExperience with behavioral health billingExperience with nonprofit community-based organizations serving similar populationsPractical orientation — evidence that the consultant can work effectively with the Compass teamSpecific experience with California Medi-CalFamiliarity with San Francisco behavioral health landscapeExperience with county MHP contractingCompany OverviewTo help homeless families and families at imminent risk for homelessness to achieve housing stability & family well-being It was founded in 1914, and is headquartered in San Francisco, California, USA, with a workforce of 51-200 employees. Its website is http://compass-sf.org/.