Medicaid Specialist

Our outstanding teachers, support staff members and leaders are top-notch educators whom others seek to emulate, and quite simply - we would like for you to consider joining us.

General Description:

Coordinates and manages all components of Medicaid administrative billing and reimbursement for services. Supervises support and professional staff assigned to assist with the implementation of Medicaid reimbursement and other special projects as assigned. Contacts are regularly and frequently made at all organizational levels within and outside the department to explain and implement programs and policies; professional judgment is required.

Job Description:

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Essential Job Functions:

Coordinates and manages all components of Medicaid administrative billing and Medicaid reimbursement for services. Supervises support and professional staff assigned to assist with the implementation of Medicaid reimbursement and other special projects as assigned. Interprets, implements and communicates School Board policies and administrative rules and regulations relating to online IEP programs and Medicaid reimbursement. Analyzes, coordinates and assists in the development of the necessary policies related to Medicaid, online IEP programs and student information systems applicable to special projects assigned. Establishes, develops, implements and monitors procedures pertinent to Medicaid Reimbursement, Administrative Billing/Claiming and other special projects as assigned. Identifies training and educational needs of staff responsible for implementing Medicaid reimbursement, online IEP services, student information systems applicable to special projects and other assigned initiatives. Provides training to ensure compliance with regulations and mandates. Writes and revises standard operating procedures relative to Medicaid reimbursement, online IEP programs and applicable student information systems. Leads the development of RFP's and fulfills purchasing and finance requirements regarding Medicaid reimbursement. Analyzes and prepares appropriate recommendations for solutions to problems and communicates issues and concerns among departments, including Exceptional Education, Human Resources, Information Technology, Instructional Support Services and School Administrative Services. Communicates and develops working relationships among vendors involved in Medicaid billing, the Virginia Department of Education (VDOE), the Virginia Department of Medical Assistance Services (DMAS), Chesterfield County Public School departments and the University of Massachusetts Medical School (UMASSS) in complying with all requirements for Medicaid billing. Develops and presents reports that address program implementation and program evaluation pertaining to Medicaid reimbursement and other special projects. Implements recommendations of program evaluations regarding Medicaid and other projects. Demonstrates commitment to improving professional competence. Assesses student learning on an ongoing basis and alters instruction to meet group/individual needs. Uses the curriculum of the district to plan daily instructional activities. May perform other duties as assigned.

Budgetary Responsibility:

N/A Report Preparation:

Prepares reports related to program implementation and evaluation, Medicaid reimbursement and other special projects.

Equipment Operation:

Utilizes a personal computer and general office equipment.

Contacts:

Contact with all levels of CCPS personnel and various outside agencies on a daily basis to obtain and provide information.

Work Direction:

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Supervision:

xxx

Decision Making:

High level of independent decision making in collaboration with the director.

Formal Policy-Setting Responsibilities:

Assists with recommendations regarding the development, review and/or revision of related policies.

Physical Demands:

The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to use hands to find, reach with hands and arms, handle paper files, records, computer and equipment controls and talk and hear. The employee is occasionally required to stand, walk, drive, stoop or kneel and light lifting up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision and the ability to adjust focus.

Work Environment:

The employee regularly works in an office setting. The noise level in the work environment is quiet to moderate.

Qualifications:

Considerable knowledge of special education program requirements, regulations and processes. Working skill in the use of a personal computer, utilizing word processing, spreadsheet, presentation and database software (Microsoft Word, Excel, PowerPoint preferred) and the use of the Inter/Intranet. Demonstrated ability to communicate effectively, both orally and in writing; to train and advise staff; to gather data and prepare and present reports. Demonstrated ability in decision making, problem analysis, conflict resolution, interpersonal relationships, program management and research and planning. Demonstrated ability to plan, organize and perform work independently and as a member of a team.

Additional Job Requirements:

Education, training and experience sufficient to demonstrate the knowledge, skills and abilities. Applicants considered for employment must successfully complete the following background investigations/tests: Federal Bureau of Investigation (FBI) Criminal History Investigation State Police Criminal History Investigation Child Protective Services (CPS) Investigation Tuberculosis Screening/Test Compensation $73,934.97 - $125,700.37 Hours Per Day 8 Days Per Year 260 Benefits Chesterfield County Public Schools offers a wide variety of benefits to employees. Benefit offerings may differ based upon full-time and part-time employee status. Chesterfield County Public Schools assures Equal Employment Opportunities for employees as required by Federal and State Orders and Laws. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential tasks. This job description is intended to accurately reflect the position activities and requirements. However, administration reserves the right to modify, add, or remove duties and assign other duties as necessary. It is not intended to be and should not be construed as an all-inclusive list of all the responsibilities, skills, or working conditions associated with the position and does not imply an employment contract. As one of the largest and most innovative school divisions in the nation, Chesterfield County Public Schools is committed to creating a better tomorrow through authentic and captivating learning experiences. With work guided by the values of equity, integrity, teamwork and ingenuity, we believe that a better tomorrow is created one student at a time. Through our strategic plan, Imagine Tomorrow, our focus is to create an infinite learner mindset while encouraging students and staff to exemplify personal responsibility and supportive relationships. We think our schools are pretty amazing, but we aren't the only ones. Our award-winning school division - which includes six National Blue Ribbon Schools, seven National Title I Distinguished Schools and six Middle Schools to Watch - is often cited as the reason people choose to live and work here. Educators from outside of our school division routinely visit our nationally-recognized schools to learn more about what we are doing, how we are doing it and why we are doing it. Our outstanding teachers, support staff members and leaders are top-notch educators whom others seek to emulate, and quite simply - we would like for you to consider joining us. You have a choice to make, and we would like for you to choose Chesterfield.