Medicaid Facilitator

Job Summary

The Medicaid Facilitator manages and coordinates all aspects of the Medicaid program for the elementary school district. Key objectives include ensuring compliance with state and federal regulations, processing claims, and maximizing reimbursement opportunities. The Facilitator collaborates with school administrators, teachers, and healthcare providers to ensure eligible students receive appropriate services.

Key Responsibilities

1. Medicaid/AHCCS Program Management

• Oversee the district's Medicaid program for compliance with state and federal regulations.
  
   
• Develop and implement policies/procedures for Medicaid services and billing.
  
   
• Stay updated on changing Medicaid regulations and guidelines.
  
   

2. Claims Processing and Billing

• Coordinate and process billing for eligible services provided to students.
  
   
• Verify student eligibility and maintain accurate records.
  
   
• Prepare and submit reimbursement claims in a timely manner.
  
   
• Track and reconcile claims to ensure accuracy and completeness.
  
   

3. Compliance and Documentation

• Ensure proper documentation of services from healthcare professionals (e.g., speech and occupational therapists).
  
   
• Conduct regular audits for documentation compliance.
  
   
• Maintain detailed records of claims, payments, and adjustments.
  
   

4. Training and Support

• Train school staff and service providers on billing procedures and compliance.
  
   
• Act as a resource for staff regarding Medicaid-related issues.
  
   

5. Collaboration and Communication

• Collaborate with administrators and special education teams to coordinate student support.
  
   
• Communicate with parents/guardians regarding Medicaid eligibility and services.
  
   
• Liaise with state Medicaid offices and external agencies.
  
   

6. Reporting and Analysis

• Generate and analyze billing and reimbursement reports.
  
   
• Monitor trends in claims to identify improvement opportunities.
  
   
• Provide regular program status updates to district leadership.
  
   

7. Program Development and Improvement

• Implement strategies to maximize reimbursement opportunities.
  
   
• Maintain relationships with external partners and state agencies.
  
   
• Assist in developing grant applications or funding opportunities.
   

Preferred Qualifications

• Education: Bachelor's degree in health administration, education, business administration, or a related field.
  
   
• Experience: Previous Medicaid billing or healthcare administration experience, preferably in an educational setting.
  
   
• Knowledge: Familiarity with Medicaid regulations, billing procedures, compliance, and special education programs.
  
   
• Skills: Strong organizational, analytical, communication, and interpersonal skills.
  
   
• Technical: Proficiency in data management and reporting software.
  
   

• Certification: Certification in Medicaid administration or a related field.

   

Work Environment

Primary work is in an office environment within the district's administrative building.  Occasional travel to schools within the district may be required.

Reports to: Executive Director of Student Services & Extended Learning
 

Salary: Classified Salary Schedule Range: 25