Medicaid/MAC Specialist

1.0 FTE on a 260 day work calendar

Location:  Albany, OR

Competitive salary and benefits package

If you are interested in this position you can:

Apply at http://www.lblesd.k12.or.us/employment

Studies have shown that women and people of color are less likely to apply for jobs unless they believe they meet every one of the qualifications as described in the job description. We are most interested in finding the best candidate for the job, and that candidate may be the one who comes from a less traditional background. We would encourage you to apply, even if you don’t believe you meet every one of our qualifications described. If you are unsure whether you meet the qualifications of this position, or how this would be determined, please feel free to contact the Executive Human Resource Officer, Kate Marrone:  kate.marrone@lblesd.k12.or.us. to discuss your application. 

Medicaid/MAC Specialist – Strategic Partnerships for Student Success

Classification:   Classified 260-Day Calendar

Reports to:   Director of Strategic Partnerships for Student Success

FLSA Status:  Non-Exempt

POSITION OVERVIEW

The Medicaid/MAC Specialist is a unique and essential support role for our districts and the agency. This one-of-a-kind position provides oversight for the implementation and operations of Medicaid Administrative Claiming (MAC) and fee-for-service billing for services provision to students.   Compliance and adherence to Medicaid policy is an important aspects of this self-paced and independent specialist.  In addition, this pivotal person provides technical training and is a resource to district users.  This position is the first call for customer service problem-solving and support. This work will provide complex challenges and rewards, as well as provide ongoing learning and growth.

QUALIFICATIONS

1.       High school diploma or equivalent.

2.       Four years of successful administrative assistant experience preferred.

3.       Previous successful experience in education or health and human services positions preferred.

4.       Demonstrated knowledge of the Medicaid Billing & Administrative Claim (MAC) Survey and Systems preferred.

5.       Competence in effective group training, designing and implementing training, documentation systems, and coordinating multi agency projects.

6.       Demonstrated effective interpersonal communication skills, including effective use of telecommunication systems.

7.       Demonstrated knowledge and skills using, with a high level of accuracy, word processing, database, and spreadsheet software.

8.       Working knowledge of basic office procedures and the operation of common office equipment and machines.

9.       Ability to understand and follow oral and written directives.

10.    Ability to use judgment in the prioritization of completing work assignments with minimal supervision.

11.    Such alternatives to certain above qualifications may apply as deemed appropriate by the Superintendent and/or Board of Directors.

GENERAL INFORMATION

This position has the following expectations and prerequisite abilities.

1.       Promotion of equity and diversity in all settings and understanding and commitment to anti-racists principles.

2.       Maintain a high level of confidentiality in accordance with HIPAA, FERPA and adherence to the competent and ethical educator practices.

3.       Maintain compliance with state and federal laws governing all aspects of our agency including ORS, OAR, IDEA, FOIA, and CIPA.

4.       Exceptional prioritization of tasks, timely completion of work assignments, ability to take the initiative and work independently with minimal supervision.

5.       Demonstrates respectful, flexible and effective team building skills of cooperation, communication and active participation.

6.       Present self and LBL in a professional manner including: in oral and written communication, professional disposition when working with others and maintaining professional dress standards.

7.       Ability to understand and follow oral and written directives, find requested data and present in user-friendly formats for internal and public distribution.

8.       Maintain regular attendance at work.  Be punctual in meeting deadlines, attending meetings, and following schedules.

9.       Utilize teleservice platform to provide services to educators, students and district staff as directed.

10.    Ability to lift, carry at least 25 pounds.

11.    Ability to sit for extended periods of time in a vehicle or work setting.

ESSENTIAL FUNCTIONS

This is not necessarily an exhaustive or all-inclusive list of responsibilities, skills, and duties associated with this position.  The supervisor of this position may modify this list at any time it’s deemed necessary.

1.       In collaboration with business manager and program director, maintain MAC intergovernmental agreements with Department of Human Services (DHS) and sub-agreements with local districts and partners.

2.       Work as a conduit between DHS and local operations regarding MAC policy and program information, requests for information, frequently asked questions, inquiries of state or federal guidance and other communications.

3.       Provide timely information to subcontractors regarding MAC training, survey process, cost pool development and claiming.

4.       Manage all aspects of the MAC quarterly survey process including materials distribution, random selection of survey participants, scoring and summarizing of survey forms.

5.       Compile, produce and disseminate all MAC claiming reports and the MAC annual report.

6.       Assist MAC sub-contractors in complying with state and federal guidelines in all MAC applications (i.e. time study process, cost pool development, claiming calculation and training).

7.       Develop support documentation guidelines and conduct periodic claiming process and file audits with MAC sub-contractors.

8.       Develop a trainer of trainers consortium and provide MAC training to sub-contractors in compliance with state and federal guidelines including documentation to substantiate training.

9.       Manage all aspects of the MAC claiming process including review, compilation and submission of quarterly claims, corrections and resubmissions.

10.    Assist DHS by attending MAC coordinator meetings and assisting state or federal auditors in their work.

11.    Maintain and update fee-for-service quality control procedures based on Oregon Medical Assistance Program (OMAP) and Education Based Medical Corporation (EBMC) guidelines and audit results.

12.    Provide training to ESD fee-for-service providers and quality control support personnel regarding current rules, procedures, services logs and other required documentation.

13.    Coordinate with the ESD business office the eligibility, claiming and reimbursement procedures of Medicaid fee-for-service billing.

14.    Establish and maintain cooperative and harmonious relationships with DHS, ESD and districts.

SALARY AND BENEFIT INFORMATION

·        Salary and benefit information shown are based on full-time employment (1.0 FTE)

         based on the current school year

·        Placement on the Linn Benton Lincoln ESD Classified salary schedule will be

         commensurate with applicant’s qualifications, relevant training, and experience

·        Linn Benton Lincoln ESD will provide an Insurance CAP to assist with health,

         dental and vision insurance premiums 

·        Employer paid PERS, holidays, sick leave and personal days are also provided

·        Employer paid Life Insurance 1 x annual salary

·        Employer paid Basic AD&D and Long Term Disability

·        May qualify for a Cell Phone/Data Stipend

·        260 day classified employees are eligible for vacation days

Health Insurance

Oregon Educators Benefit Board (OEBB) provides insurance to school and education service district employees

o   Includes medical, dental, vision & prescription insurance

o   Monthly premium deducted pre-tax

o   LBLESD contributes a monthly CAP/Pool to help offset insurance cost

o   Health Savings Accounts for high deductible plans

o   Flexible Spending Accounts

Carriers offered are:

·        Moda

·        Kaiser

·        Willamette Dental Group

Retirement

·        PERS – Public Employee Retirement System

·        For more information visit:  pers.state.or.us

·        LBLESD pays the 6% employee contribution on behalf of each employee

Personal Leave

·        Up to 24 hours

Sick Leave

·        Up to 96 hours (prorated based on work calendars less than 260)

·        Sick Leave Bank

o   Employees may opt to donate one day of sick leave to become a member of the Sick Leave Bank

o   Members may request leave from the sick leave bank in the event of a catastrophic illness or injury

Doctor Appointment Leave

·        Up to 3 hours per month

Professional Development Opportunities

·        LBLESD hosts a variety of training classes

·        First Aid/CPR classes offered onsite

·        Includes workshops and conferences

Reasonable accommodations for the application and interview process will be provided upon request and as required in accordance with the Americans with Disabilities Act of 1990.  Individuals with disabilities may contact Human Resources at 541-812-2624 for additional information and assistance.  

Linn Benton Lincoln ESD is an Equal Opportunity/Affirmative Action employer. 

Qualifying veterans and disabled veterans may obtain preference by submitting with their completed application a copy of the Certificate of Release or Discharge from Active Duty (DD Form 214 or 215) or a letter from the US Dept. of Veteran's Affairs indicating receipt of a non-service connected pension as verification of eligibility.  Disabled Veterans must also submit a copy of their veteran's disability preference letter from the Dept. of Veteran Affairs, unless the information is included in the DD Form 214 or 215.

Salary : $26 - $35