Medicaid Billing Specialist

JOB GOAL:

Under general direction, provides support to the Division of Special Programs to maximize reimbursement from Medicaid for services provided to students with disabilities. Performs responsible and confidential administrative functions; performs other related duties as assigned.

TERMS OF EMPLOYMENT:

12-month contract (240 days) Salary Schedule Code 804 – Range 112, Plus Benefits Package NOTE: Precise placement on the salary schedule will be determined based upon experience. FLSA: Non-Exempt  

QUALIFICATIONS:

1. High school diploma or GED required.  Associate or bachelor degree from a college or university preferred.
2. Advanced computer skills. Demonstrated knowledge and skills in standard office administration programs such as Microsoft programs (Word, Excel, PowerPoint) and data processing.
3. Minimum of two years’ experience as an office/Medicaid billing secretary preferred.
4. Evidence of strong organizational, oral/written communication, and interpersonal skills.

ESSENTIAL DUTIES & RESPONSIBILITIES:

The following statements of duties and responsibilities are intended to describe the general nature and level of work being performed by individuals assigned to this position. These statements are not intended to be an exhaustive list of all duties and responsibilities required of all personnel within this position.

1. Collects, organizes, and reviews documents for Medicaid that comply with regulations, medical necessity, and legal requirements, including securing prescriptions from physicians.
2. Facilitates the billing process and submits all Medicaid claims for OT, PT, Speech Therapy, and Paraprofessional services. 
3. Maintains student database for eligibility status.
4. Maintains accurate records for audit and works with agencies during the audit process.
5. Actively pursues records from school staff to maximize the District’s Medicaid reimbursement, and reports any issues affecting reimbursement to Leadership Team.
6. Files special education and Section 504 records. Processes internal and external records requests; scans, faxes, mails records in a timely manner.
7. Answers the phone, assists office visitors, and communicates with Special Programs staff regarding urgent issues.
8. Promotes a positive atmosphere in the office at all times.
9. Offers to assist other clerical staff to ensure office efficiency and performs other duties as assigned.
10. Seeks all methods and allowable services that are reimbursable for the department.

Requirements are representative of minimum levels of knowledge, skills, and/or abilities. To perform this job successfully, the incumbent will possess the abilities or aptitudes to perform each duty successfully. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Mental Functions, Physical Requirements, and Working Conditions:

While performing the duties of this job, the employee is regularly required to sit, stand, walk, go up and downstairs, operate foot and hand controls, use a telephone, and write. Occasionally the employee must lift and/or move up to twenty (20) or more pounds. This position requires accurate perceiving of sound, near and far vision, depth perception, handling and working with educational materials and/or objects, and providing oral information. Must have the ability to work for the duration of the daily contracted time period, and to be physically present and at assigned work, with only infrequent unexcused absences, during the contract year. Additional technical skills, knowledge, and abilities may be recommended by the immediate supervisor and approved by the Human Resources Director.