Medicaid Compliance Specialist
Location: J.O. Combs Unified School District #44
Reports To: Director of Student Services
Position Type: Classified – Non-Exempt
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Position Summary
The Medicaid Compliance Specialist ensures compliance with federal and state Medicaid billing regulations. This position supports special education staff in accurately documenting, submitting, and maintaining service records for eligible students, with the goal of securing reimbursement. Regular, reliable attendance is essential for success in position.
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Key Responsibilities
1. Responsible for knowing all compliance requirements for Medicaid in the Public Schools (MIPS).
2. District liaison for MIPS (Special Education staff, Arizona staff, 3rd Party Billing Staff).
3. Create and accurately maintain student MIPS files.
4. Provide training to ESS staff to maintain current provider registration status.
5. Coordination of required CPR and First Aide Training for ESS staff.
6. Ensure that ESS staff maintains current provider registration status.
7. Review all DSC togs and ESS paperwork for compliance according to district, state, and federal guidelines prior to submission for billing.
8. Maintain student database and inform the billing agent of changes in student status.
9. Maintain and coordinate documentation, records and staff requirements for annual DSC audit.
10. Maintain confidentiality regarding student records and personal information.
11. Coordinate annual MIPS audit.
12. Generate and submit reports to district administration and state agencies.
13. Familiarization of procedures and protocols for AHCCCS applications (Arizona & Medicaid Agency).
15. Perform other duties as assigned by the Superintendent or designee.
16. Review IEPs and service logs to ensure alignment with Medicaid-eligible services.
Monitor provider documentation for accuracy, completeness, and timeliness.
Maintain up-to-date knowledge of state Medicaid rules, billing requirements, and allowable services.
Ensure service logs, progress notes, and provider credentials meet Medicaid documentation standards.
Provide technical assistance to staff to address documentation, logging, billing and compliance issues and updates.
Conduct internal audits of IEP records and service delivery to identify trends and correct errors before submission.
Qualifications:
Preferred bachelor’s degree in education, health administration, or related field.
Knowledge of or willingness to learn IDEA, Section 504, and Medicaid billing requirements in an educational setting.
Experience in special education compliance, Medicaid billing, or related areas preferred.
Strong organizational skills with attention to detail and accuracy.
Ability to interpret and apply complex regulations.
Effective communication and training skills for working with diverse school staff.
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Physical Demands
Regularly required to stand, sit, talk, and hear.
Occasionally required to use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; bend, stoop, kneel, or crouch.
Must lift and carry up to 25 pounds.
Specific vision abilities: close vision, distance vision, color vision, peripheral vision, and ability to adjust focus.
Work Environment
May be exposed to outside weather conditions including extreme heat or cold, wind, or rain.
High humidity and/or dusty conditions possible.
Noise level in the work environment is usually moderate.
Position Details
Salary Schedule: Support Staff Initial Salary Placement Range 114 (N)
Benefits: Per District Policy
Evaluation: Annual
Contract: 12 Months
Hours: Full-time, 8 hours per day
Reports To: Director of Student Services
FLSA Status: Non-Exempt
Equal Opportunity Employer
J.O. Combs Unified School District #44 does not discriminate on the basis of race, color, religion, national origin, sex, disability, age, or sexual orientation and provides equal access to the Boy Scouts and other designated youth groups.
Compliance Officers:
Title IX: Assistant Superintendent, Human Resources | 43371 N Kenworthy Road, San Tan Valley, AZ 85140 | 480-987-5318
Section 504/ADA: Director of Student Services | 43371 N Kenworthy Road, San Tan Valley, AZ 85140 | 480-987-5300
