Claims Specialist (CalAIM AR Follow-Up)

I am looking for an experienced and detail-oriented CalAIM AR Follow-Up Specialist to support our Accounts Receivable team. The ideal candidate has hands-on experience managing outstanding claims, researching payment issues, resolving denials, and following up with Medi-Cal Managed Care Plans to ensure timely reimbursement.



What You’ll Do



Manage accounts receivable follow-ups and monitor outstanding insurance claims and unpaid balances.

Research claim statuses, identify payment delays, and coordinate the necessary steps to resolve billing issues.

Review denied and underpaid claims, determine the reasons for denial, and submit appeals or corrected claims as needed.

Follow up with Medi-Cal Managed Care Plans regarding pending claims, payment discrepancies, and outstanding reimbursements.

Reconcile payments and investigate discrepancies to ensure accurate account records.

Monitor AR aging reports, prioritize overdue accounts, and implement follow-up strategies to recover outstanding balances.

Maintain accurate documentation of claim activity, payer communications, appeals, and collection efforts.



What I’m Looking For



Previous experience in accounts receivable follow-up, medical billing, or healthcare collections.

Familiarity with CalAIM and Medi-Cal Managed Care Plans.

Hands-on experience with claim status research, denial management, appeals, payment reconciliation, and aging accounts.

Strong attention to detail and the ability to investigate issues and follow through until resolution.

Good communication, organization, and problem-solving skills.

Ability to manage a high volume of accounts while maintaining accurate records and consistent follow-up.