What are the responsibilities and job description for the Medicaid Specialist position at Wallowa County Chamber of Commerce?
DEPARTMENT: Health Services
TERMS OF EMPLOYMENT: 1.0 FTE
LENGTH OF POSITION: 258 days
WAGE: $25.17 - $30.11 per hour
IMMEDIATE SUPERVISOR: Director of Student Health Services
OPEN: Until Filled
General Summary
Wallowa County Education Service District is seeking a Medicaid Specialist with Medicaid Administrative Claiming (MAC) and Fee-For-Service billing experience. The MAC program provides a way of reimbursing districts for claimable work already being performed by staff members in the schools. The MAC Specialist is responsible for providing live professional development training to local school district staff including building and district administrators, educators, and office personnel. The MAC Specialist works in collaboration with WESD and school district business managers and Oregon Department of Human Services. Locally, the MAC Specialist collects, compiles, and tracks data submissions in real time per state and federal guidelines. Concise and timely written and oral communication is essential to this position as are attention to detail and timelines. The successful candidate should enjoy working with people as much as they do with data.
POSITION GOAL: Provide oversight for the implementation and operations of Medicaid administrative claiming (MAC) and fee-for-service billing to ensure that Medicaid policy decisions and procedures are implemented appropriately.
Essential Functions
and spreadsheet applications.
Wallowa County ESD reserves the right to reject any or all applications and to not fill the position or to post it again.
TERMS OF EMPLOYMENT: 1.0 FTE
LENGTH OF POSITION: 258 days
WAGE: $25.17 - $30.11 per hour
IMMEDIATE SUPERVISOR: Director of Student Health Services
OPEN: Until Filled
General Summary
Wallowa County Education Service District is seeking a Medicaid Specialist with Medicaid Administrative Claiming (MAC) and Fee-For-Service billing experience. The MAC program provides a way of reimbursing districts for claimable work already being performed by staff members in the schools. The MAC Specialist is responsible for providing live professional development training to local school district staff including building and district administrators, educators, and office personnel. The MAC Specialist works in collaboration with WESD and school district business managers and Oregon Department of Human Services. Locally, the MAC Specialist collects, compiles, and tracks data submissions in real time per state and federal guidelines. Concise and timely written and oral communication is essential to this position as are attention to detail and timelines. The successful candidate should enjoy working with people as much as they do with data.
POSITION GOAL: Provide oversight for the implementation and operations of Medicaid administrative claiming (MAC) and fee-for-service billing to ensure that Medicaid policy decisions and procedures are implemented appropriately.
Essential Functions
- In collaboration with WCESD business manager, maintain MAC intergovernmental agreements with Department of Human Services (DHS) and sub-agreements with local districts and partners.
- 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.
- Provide timely information to subcontractors regarding MAC training, survey process, cost pool
- Manage all aspects of the MAC quarterly survey process including materials distribution, random selection of survey participants, scoring and summarizing of survey forms.
- Compile, produce and disseminate all MAC claiming reports and the MAC annual report.
- 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).
- Develop support documentation guidelines and conduct periodic claiming process and file audits with MAC sub-contractors.
- 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.
- Manage all aspects of the MAC claiming process including review, compilation and submission of
- Develop and facilitate the MAC local advisory group in the reinvestment of funds.
- Assist DHS by attending MAC coordinator meetings and assisting state or federal auditors in their work.
- 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.
- Provide training to ESD fee-for-service providers and quality control support personnel regarding current rules, procedures, services logs and other required documentation.
- Coordinate with the ESD business office the eligibility, claiming and reimbursement procedures of Medicaid fee-for-service billing.
- Establish and maintain positive, flexible, and collaborative relationships with DHS, ESD and districts.
- Make independent decisions within established policies and procedures.
- Participate in annual professional growth activities.
- Comply with ESD rules and policies.
- Perform physical requirements unaided or with the assistance of reasonable accommodation (see reverse).
- Perform job-related tasks as designated by supervisor.
- Establish and maintain cooperative work relationships with WESD employees, local education agency representatives and others contacted during the course of the workday.
- Some travel required for attending trainings or to present a training.
- Experience with Medicaid billing/MAC Survey
- Competence in effective group training, oral and written communication skills, designing and
and spreadsheet applications.
- Previous successful experience in education or health and human services positions preferred.
Wallowa County ESD reserves the right to reject any or all applications and to not fill the position or to post it again.
Salary : $25 - $30