Reports To: Executive Director of Special Services
Contract Length: 12 Months
EXECUTIVE SUMMARY
The Special Education Medicaid Specialist is responsible for effectively and efficiently managing special education records, claims, and billing. The primary role includes management of all Medicaid claims and processes. Additional responsibilities include billing for partner agencies and other responsibilities to support the efficient operation of Special Education procedures and management tasks.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
Adheres to Board policies, district procedures, and contractual obligations.
Develops, maintains, manages and balances the Medicaid billing reimbursement program for all SPED programs. Develops procedures for Medicaid documentation and reimbursement and ensures compliance.
Demonstrates professional and instructional leadership, models professional and ethical behavior, and maintains professional confidentiality.
Monitors Medicaid billing data and systems for both direct and administrative claims. Submits and monitors all aspects of Medical billing, re-billing, and payments in accordance with Medicaid policies and procedures.
Coordinates all billable services (i.e., skilled nursing, psychological, behavior, etc.). Creates, maintains and provides supporting documentation and provider qualifications.
Oversees and administers Medicaid compliance programs such as time study, narrative logs, and coding issues.
Creates procedure manuals, documentation, checklists, or guidelines as necessary.
Prepares quarterly reports and present information to the Executive Director of Special Services and Student Supports
Prepares, maintains and reviews all student Medicaid files. Ensures files meet requirements for annual audits or review.
Stays abreast of changes and developments in the Medicaid reimbursement program and attends Medicaid meetings or continuing education sessions conducted by state or federal agencies.
Acts as District liaison with appropriate government agencies.
Oversees all components of Medicaid claiming responsibilities, including collection and organization of claims, accurate reporting and alignment with Medicaid procedures and requirements, and submitting required claims and reports in a timely manner.
Designs and provides training and support to teachers, para-educators, and other staff involved in Medicaid claiming.
Manages and maintains accurate special education records.
Works collaboratively with staff at the district, building, AEA, and state level.
Resolves concerns.
Maintains confidentiality of sensitive data and student information.
Completes other duties as assigned.
ESSENTIAL FUNCTIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation(s) may be made to enable individuals with disabilities to perform the essential functions.
Ability to work as a member of a multidisciplinary team.Ability to develop professional learning and train school personnel
Excellent written and oral communication skills including proficiency in grammar, spelling, punctuation, and related communication skills, including proofreading, editing, and creating original documents.
Ability to work independently without supervision and as a team member.
Ability to work under pressure with frequent interruptions, problem solve independently and with others, and take initiative.
Ability to organize, prioritize, and assume responsibility.
Ability to take initiative, be creative, and generate enthusiasm in others.
Capable of representing the District in a professional manner, which includes but is not limited to confidentiality, collegiality, and the ability to obtain and utilize additional training, if necessary.
EDUCATION and/or EXPERIENCE:
Bachelor’s Degree
Experience with Medicaid Claiming
Experience with leading change in an organization
LANGUAGE SKILLS:
Ability to read, analyze, interpret, and implement ideas contained in technical documents, reports, regulations, etc. Ability to effectively write reports and communications to administrators, colleagues, parents, students and staff. Ability to effectively present information orally and respond to questions from administrators, teachers, staff and students.
MATHEMATICAL SKILLS:
Ability to perform basic mathematical functions. Ability to use spreadsheets and reporting documents that assist with the computation of data.
REASONING ABILITY:
Ability to solve problems effectively. Ability to interpret and implement a variety of instructions furnished in written, oral, diagram or schedule form.
OTHER SKILLS and ABILITIES:
Ability to establish and maintain effective working relationships with administrators, colleagues, community members, staff and students. Ability to speak clearly and concisely both in oral and written communication. Ability to perform duties with awareness of all district requirements and Board of Education policies.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to stand; walk; use hands and fingers to handle and/or feel objects, tools or controls; and talk and hear. The employee will frequently use hands and fingers to type/word process, file documents, manipulate papers, and use a copying machine. The employee frequently must squat, stoop or kneel, reach above the head and forward 0 -24 inches and on occasion up to 36 inches. The employee continuously uses hand strength to grasp items. The employee will frequently bend or twist at the neck and trunk while performing the duties of this job. The employee must occasionally lift and/or move up to 50 pounds 0 - 12 feet and occasionally up to 20 feet, such as office materials, desks, chairs, and boxes. The employee will sometimes push/pull items such as tables and carts. Specific vision abilities required by this job include close vision, color vision and the ability to adjust focus while working with computers, written materials, reports, assessment data, etc.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is often quiet but may become loud in large group settings. The position requires the commitment of professional working hours that will require the employee arrive and leave as directed and may require the employee to extend beyond a typical 7:30 a.m. to 4:30 p.m. workday. The employee will usually work in indoor temperatures but will be required to work occasionally in outdoor environments.
AN EQUAL OPPORTUNITY EMPLOYER
The Cedar Rapids Community School district is an Equal Opportunity Employer. The district does not discriminate on the basis of race, creed, color, gender, national origin, religion, age, marital status, sexual orientation, veteran status, or disability.
Federal law obligates an employer to provide reasonable accommodation for the known disabilities of applicants, unless doing so would pose an undue hardship on the employer. If you or someone you know requires accommodation in the hiring process, contact the Executive Director of Human Resources at 319-558-2747.
