Medicaid Billing Specialist
Job Title: Medicaid Billing Specialist
Reports To: Director of Pupil Personnel Services
PRIMARY RESPONSIBILITIES:
• The Medicaid Billing Specialist performs all assignments coordinating the Medicaid Billing in the Public School Program on behalf of the Director of Pupil Personnel Services and Franklin County Public Schools.
• Maintains and monitors the Regional Program’s provision of related services for regional students.
• Maintains a confidential Medicaid Student List.
• Trains related services personnel on procedures to document Medicaid Billing on each student that qualifies. Verifies parental written consent for Medicaid Billing.
• Arranges long-term substitutes for related services personnel and trains them on Medicaid Billing.
• Works with the Learning Works to prepare all Medicaid Billing for FCPS/Pupil Personnel Services.
• Files all Medicaid Billing in regards to all students eligible for such billing as to meet these timelines; maintains record of such filings; keep the director abreast of all reimbursements and completes this portion of the budget for Pupil Personnel Services each year.
• Completes any additional tasks assigned by the Director of Pupil Personnel Services.
QUALIFICATIONS:
• Must be trained in and participate in yearly Medicaid Billing Procedures by the Virginia Department of Education.
• Establish a contact to serve as a resource with VDOE
• Works with the representatives from Learning Works (Medicaid Billing Agency)
• Hold a two-year college degree and has 5 years of experience in working with Medicaid Billing
• Two years of work experience in the area of Special Education.
• Working knowledge of word processing, database and spreadsheet applications.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively to employees of the organization.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
PERFORMANCE DUTIES AND RESPONSIBILITIES:
• Responsible for knowing all compliance requirements for Medicaid in the Public Schools (MIPS). Serve as District liaison for MIPS. Special Education (SE) staff, and 3rd Party Billing Staff.
• Maintain enrollment and registration with the Virginia Department of Medical Assistance Services (DMAS) and their contractors so that Franklin County Schools can participate in MIPS program and receive Medicaid eligibility data.
• Create and maintain student MIPS files
• Provide training to SE staff regarding Medicaid Billing process, paperwork, compliance and provider registration.
• Coordination of Required Related Services
• Review all MIPS logs and SE paperwork for compliance according to district, state and federal guidelines prior to submittal for billing.
• Maintains student database and inform billing agent of student changes in status. Prepare student files and staff requirements for annual MIPS audit.
• Coordinate and prepare documentation for quarterly administrative claims and annual cost report and self-audit.
• Generate reports
• Answer the telephone in a courteous and professional manner; route all calls to the appropriate person(s) and take written messages in an efficient manner.
• Performs other duties as assigned by the Director of Pupil Personnel Services.
TERMS OF EMPLOYMENT:
Twelve Months Position with salary and conditions established by the Franklin County School Board.
EVALUATIONS:
Performance on this job will be evaluated annually in accordance with school board policy and administrative regulations that address evaluation of classified personnel.