Special Education Medicaid Specialist bei Corpus Christi Independent School District

Education/Certification:

• Required: High School Graduate 
• Preferred: 60 College Hours/Associate 's Degree

Special Knowledge/Skills:

• Positive attitude
• Ability to adapt quickly to new situations and assignments
• Have the ability to maintain good rapport with school staff, students, and parent(s)/guardian(s)
• Knowledge of special education and related services within a school district
• Knowledge of Medicaid billing and Medicaid definition of billable services
• Knowledge of Medicaid required random moment time studies and eSHARS system preferred
• Ability to use software to develop spreadsheets and databases, and do word processing
• Ability to properly answer phone calls and disseminate messages as appropriate
• Proficient keyboarding, file maintenance skills and 10-key skills
• Experience with data entry and record keeping
• Excellent organizational, communication, and interpersonal skills
• Problem solving skills
• Detail oriented and ability to meet established deadlines

Technology Proficiency: Level 2- Proficient (in):

• Applied use of computer operations
• Applied use of software productivity tools (i.e., Microsoft Office)
• Applied use of e-mail
• Applied use of printers
• Applied use of job-related financial and student management systems
• Applied use of multimedia tools
• Applied use of electronic file management
• Applied use of Technology Applications TEKS CC/SO Acceptable Use Policy and Technology Ethics/Etiquette

Experience:

• Required: Three years of data entry experience

Function

The Special Education Medicaid Specialist is responsible for all phases of processing Medicaid claims for special education students. This includes but is not limited to the interfaces of the School Health and Related Services (SHARS), Medicaid Administrative Claiming (MAC), and current Medicaid billing service. The Medicaid Specialist will submit claims for reimbursement for Medicaid eligible services, maintain security procedures to protect the confidentiality of student records, and monitor compliance with state and federal regulations.

Reports To:

Coordinator for Accountability/Senior Director

Responsibilities:

• Answer phones and, if needed, relay messages to appropriate staff
• Identify and train employees providing services under the Student Health Related Services (SHARS) program and the Medicaid Administrative Claiming (MAC) program.
• Maintain the participant list for the SHARS and MAC programs
• Compile and maintain accurate records regarding personnel funded through federal grants, including time and effort documentation
• Provide a report that reflects the changes in staff, contract labor and vacant positions on the Participant list and the reasons for the changes. The report should be completed at the close of each participant List
• Assist staff with computer and/or software problems regarding Medicaid, RMTS, or SHARS
• Complete required training for RMTS, MAC, and SHARS
• Maintain the SHARS/MAC job category coding
• Organize and maintain a record system for SHARS services
• Maintain communication with SHARS staff
• Identify students eligible for SHARS
• Reconcile remittance and status reports
• Coordinate with the Special Education Accountant to complete and submit the quarterly certification of funds
• Train participants in random-moment time study procedures
• Monitor sampled staff for compliance, documenting compliance, as required
• Perform routine audits of billing activity
• Provide required reports to third-party administrator
• Monitor and maintain documentation of provided services and activities
• Assist in developing and submitting required Medicaid reports
• Assist district personnel in documenting Medicaid billable services
• Act as liaison between District and third-party administrator's program staff
• Maintain confidentiality with regard to student records and personal information
• Provide back up support to other staff in department as needed
• Types memos, letters, etc., as needed or requested.
• Perform other duties as assigned

SUPERVISORY RESPONSIBILITIES:  None

WORKING CONDITIONS:

• Mental/Physical Demands and Environmental Factors
• Ability to communicate effectively (verbal and written); interpret policy, procedures and data; coordinate district functions and maintain emotional control under stress.
• Occasional travel within district and out of district; possible irregular and prolonged hours.
• Challenging situations and moderate to heavy lifting
• Ability to receive information and/or instruction from internal/external customers through spoken expression.
• Ability to manipulate tools/equipment/keyboards.
• Ability to convey information and/or instruction to internal/external customers through spoken expression.
• Ability to perform work while standing and/or walking for extended periods, up to eight
• (8) hours a day.
• Ability to see detailed information, naturally or with correction.

The foregoing statements describe the general purpose and responsibilities assigned to this job and are not an exhaustive list of all responsibilities, duties, and skills that may be required.

TERMS OF EMPLOYMENT:

• This job description describes the general purpose and responsibilities assigned to this job and are not an exhaustive list of all responsibilities, duties, and skills that may be required. Other duties may be assigned as deemed appropriate. The pay grade, pay code, and work year listed are intended to be informational and not contractual in nature.