146 Best hourly Jobs in Salinas, California (December 2025) - page 3

Lightfighter Village Case Manager

3 months ago

Marina

Job DescriptionSalary: 32.00 Position Summary: Reporting directly to the Supervising PSH Case Manager, the case manager coordinates and monitors the assessment, treatment planning process and follow-up for each Veterans client and/or resident and serves as an advocate and liaison for and on behalf of Veterans rights and benefits. In addition, they would be responsible for enrolling clients, preparing, reviewing, and submitting medical claims to government programs (such as Medi-Cal/Medicare) and commercial insurance carriers. This role would ensure claims are accurately coded, compliant with payer requirements, and processed in a timely manner to maximize reimbursement. The specialist also follows up on outstanding claims, resolves denials, and communicates with payers, providers, and patients as needed. Responsibilities include, but shall not be limited to, the following: • Meet with assigned residents at least once a week for pertinent Veteran client information and census. Inputs census information, case notes, and other information to Homeless Management Information System (HMIS), and other databases as required, and communicates with appropriate team members., • Assess clients throughout the VTC programs and identify and enroll those who are eligible for government programs. This can and may include previous clients of VTC programs, those currently enrolled in a program and those who are to be enrolled., • Accurately prepare and submit medical claims to Medi-Cal, Medicare, and commercial insurance providers., • Coordinates the interdisciplinary treatment planning meeting and writes Individualized Treatment Plan specific to each clients program., • Review claims for accuracy, completeness, and compliance with regulatory and payer guidelines., • Verify patient insurance coverage and eligibility., • Monitor and follow up on unpaid or denied claims, submitting appeals when necessary., • Post insurance payments and reconcile accounts., • Communicate with insurance companies, providers, and patients regarding claim status and billing inquiries., • Maintain knowledge of Medi-Cal billing rules, CPT/ICD-10 coding, and healthcare reimbursement procedures., • Generate and review aging reports to ensure timely resolution of outstanding balances., • Protect patient confidentiality and comply with HIPAA regulations., • Familiar with systems like Avatar, Beacon Health and other related Medi-Cal sites., • Ability to write FIRP notes in a clear and concise manner, • Follow up with referrals to ensure that clients receive and access necessary services in a timely manner, • Knowledge of hourly billing for Medi-Cal services, • Maintains assigned client records as required by client record procedures., • Manage Crisis Phone on a rotating schedule., • Reviews and coordinates with the team and provider on decisions involving hospitalization, respite and transfers/level-of-care changes. Implements plan of action. Maintains ongoing dialogue with intake regarding status changes., • Facilitates community resource availability based on client needs (e.g., day program, guardians) to ensure maximum social integration., • Evaluates, facilitates and monitors services and clients progress in relationship to established goals and objectives. Documents goal progress weekly., • Focuses and maintains rapport and positive client relationship as central component to treatment and case management support., • Participates in regular team and community meetings and trainings., • Monitors treatment plan follow-up, services to residents and over-all conditions in the homes. Works with housing department to coordinate work orders and make necessary improvements. Follows up problem areas with the case management supervisor and other appropriate team members., • Other duties as directed Minimum Qualifications: Must have one year of experience in medical billing or claims processing. Medi-Cal experience strongly preferred. Has the ability to use computers and has proficiency in Microsoft Office software. Familiarity with electronic medical records (EMR) and billing software Bachelors degree in human services field (e.g., social work, psychology) from an accredited college or university, or combination of education and two to five years relevant experience. Must have and maintain a valid state driver's license, maintain automobile insurance coverage, and have access to an automobile. Strong skills in advocacy, attention to detail, organizational skills, and problem-solving.

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