Medicaid Senior Specialist bei Iowa City Community School District

Iowa City Community School District

Medicaid Senior Specialist

QUALIFICATIONS:

1. Bachelor’s Degree required. 
2. Strong organizational, analytical, problem-solving, and critical thinking skills, with the ability to swiftly and accurately understand complex data and perform analyses.
3. Strong communication and interpersonal skills.
4. Ability to deal with confidential and sensitive matters in a professional manner.
5. Knowledge of applicable laws, rules, policies, and procedures as they relate to Federal and State Medicaid laws preferred.
6. Experience working in a K-12 education system is preferred.
7. Proficient in oral and written usage of the English language.
8. Knowledge of Excel, Word and Google Suite.
9. Such alternatives to the above qualifications as the District may find appropriate and acceptable.  

REPORTS TO:         Manager of Health Services 

SUPERVISES:          NA     

JOB GOALS: 

Coordinate and facilitate the implementation and management of systems to collect and process Medicaid claims within the Iowa City School District in a method that maintains compliance with State and Federal School-Based Medicaid Claim Programs.  

PERFORMANCE RESPONSIBILITIES:

1. Develop procedures pertaining to Medicaid documentation and reimbursement and ensure compliance.
2. Develop procedures for identification of Medicaid-eligible students.
3. Interface with staff to obtain parental consent forms.
4. Interface with federal, state, local, and private agencies to obtain information about eligible students.
5. Prepare, maintain and review all student Medicaid Files.
6. Coordinate all billable services; create, maintain and provide supporting documentation and ensure providers hold the appropriate licensures.
7. Act as Iowa City Community School District’s liaison with appropriate state agencies in regard to our School-Based Medicaid Claim Program. 
8. Develop and maintain Medicaid billing program for reimbursement of services. 
9. Reconcile accounts and respond to billing discrepancies.
10. Train Iowa City Community School District and Grantwood AEA staff on Medicaid requirements and procedures.
11. Prepare and review program-related correspondence.
12. Create Medicaid reimbursement training material for District implementation of Medicaid reimbursement program.  
13. Stay abreast of changes and developments in the Medicaid reimbursement program and attend Medicaid meetings conducted by state and federal agencies.
14. Collaborate with the Chief Financial officer, Special Education, and Health Services departments to obtain information on Medicaid-related activities as needed for reimbursement.
15. Train Medicaid Specialist on billing systems, Medicaid requirements, procedures and compliance. 
16. Develop and implement internal audit process of Medicaid data submitted for reimbursement.
17. Prepare Office of Inspector General (OIG) federal and state exclusion lists and search for exclusion matches.  
18. Responsible for Iowa City Community School District’s Medicaid Re-enrollment with DHS.  
19. Prepare and compile all necessary documentation for quarterly audits and work with the Department of Education Medicaid Program Consultant on all PERM/Federal Medicaid Reimbursement Audits.
20. Other duties as assigned.

TERMS OF EMPLOYMENT:    

1. Year-round contract. Salary and calendar year to be established by the Board of Education. 

EVALUATION: Performance of this job will be evaluated in accordance with provisions of the District’s policy on Evaluation, State Statute, and any applicable Collective Bargaining Agreement.