Account Specialist Senior - Medicaid

Tempe School District No.3•Tempe, AZ

4d•Onsite

About The Position

Coordinate, and implement the School-Based Medicaid Program in accordance with all applicable federal and state Medicaid laws.

Requirements

Education and/or experience equivalent to a High School Diploma or GED
Three (3) years administrative support experience, preferably in a human resources department
State of Arizona Identity Verified (IVP) Fingerprint Clearance Card
May require a valid Arizona Driver's License
Knowledge of multi-line telephone systems.
Knowledge of customer service/public relations practices and procedures.
Knowledge of principles, practices and standards of human resource administration in assigned areas.
Knowledge of teacher certifications and highly qualified requirements.
Knowledge of appropriate district policies and procedures related to the assigned
Knowledge of applicable state and federal statutes, regulations and laws governing Special Education and Medicaid Billing
Knowledge of computer software utilized in tracking and maintaining reports and accounts
Knowledge of recordkeeping/file management practices and procedures
Skill in problem analysis and resolution.
Skill verifying applicant information and completing background investigations.
Skill providing information in a clear and concise manner.
Skill utilizing, maintaining and updating computer software databases.
Skill establishing and maintaining effective working relationships.
Skill accurately inputting and retrieving information from computer databases
Skill utilizing verbal and written communication in the development of reports and records
Skill implementing policies and procedures related to area of assignment
Skill utilizing customer service/public relations techniques when responding to inquiries and complaints
Skill establishing and maintaining effective working relationships
Ability to effectively communicate with others.
Ability to maintain confidential information.
Ability to work independently in absence of supervision.

Nice To Haves

Microsoft Office and Google Drive Applications
Email
Word Processing
Spreadsheets
Databases
Presentation Software
Accounting and basic math
Use of standard office equipment

Responsibilities

Serve as the district's liaison to AHCCCS and its third-party administrator for the Medicaid in Public Schools (MIPS) program.
Monitor state and federal Medicaid rules, attend required meetings, and update district procedures to stay compliant.
Track licensure and credentials of school health providers to confirm billing eligibility.
Gather and analyze program data to solve problems, and coordinate with other districts to improve compliance and reimbursement.
Coordinate the random moment time study (RMTS), including monitoring response rates and following up on missed moments.
Maintain Medicaid-related data in the student information system and state databases.
Work with district departments to gather information needed for state and federal reporting.
Identify Medicaid-eligible students each month and share current eligibility with providers and special education teachers.
Collect and track the parental consent required under IDEA before billing, along with annual notifications.
Protect student health and education records under FERPA, HIPAA, and state and federal rules.
Review service documentation for compliance before billing submission, including personal care, nursing, and specialized transportation.
Maintain a database tracking providers, students, and billable services.
Work with special education administrators and case managers for IEP documentation related to Medicaid claiming.
Train special education providers and other staff on documentation standards, billing procedures, and RMTS responses.
Develop and update training materials, guides, and forms.
Give Medicaid updates and technical assistance at special education provider and nurse meetings.
Prepare quarterly RMTS participant rosters for direct service and administrative claiming.
Prepare, submit, and reconcile quarterly reports as required by AHCCCS.
Review provider billing reports from the third-party administrator for compliance.
Prepare and submit the annual cost reconciliation and required state reports.
Establish checks to ensure data integrity.
Participate in AHCCCS or third-party administrator compliance reviews and audits.
Perform other job-related duties as assigned.