Revenue Cycle Specialist Jobs at FQHCs

CalAIM makes CHWs, care coordinators, RNs, and BH staff into revenue generators — Enhanced Care Management (ECM) and Community Supports are billable.

How this role generates billable revenue

• Accurate claims, denial follow-up, eligibility checks, and PPS wraparound reconciliation may protect reimbursement supported by the record and payer contract
• Accurate coding and enrollment support may reduce avoidable payment loss without changing the clinical service documented
• Preventing avoidable denials and completing accurate eligibility work may protect reimbursement the FQHC has earned under its payer contracts.

Programs in California

• CalAIM Enhanced Care Management (ECM) — Billable, intensive care management for high-need Medi-Cal members — staffed by lead care managers, CHWs, RNs, and BH staff (~per-member-per-month).
• CalAIM Community Supports — Billable in-lieu-of services (housing navigation, medically tailored meals, recuperative care) that care coordinators and CHWs deliver.
• CHW Medi-Cal benefit + Dyadic & Doula benefits — CHW services, dyadic (parent-child) behavioral services, and doula care are all Medi-Cal-billable maternal/community revenue lines.

Verify current codes & programs with your state Medicaid department.