Medicaid Implementation Admin (Multiple Positions)

JOB SUMMARY

Serves as the system application technical expert for client district customer support representatives and on-line billing staff.  Trains other school districts on research, program development, implementation, and service provider licensure.  Certifies Medicaid requirements for the district and each client district’s Medicaid revenue programs.

MAJOR DUTIES & RESPONSIBILITIES

• Ensures medical billing and processing guidelines are followed.  Analyzes day-to-day activities, solves and/or prioritize assignments.  Trains client district administrators, clinicians, and teachers on the e-SHARS billing system and the Medicaid Reimbursement programs.
• Trains various client districts on system and supports services to district employees to ensure maximum Medicaid reimbursement revenue and program compliance.  Routinely travels throughout the state of Texas to provide annual Medicaid program policy/regulations and eSHARS system trainings. Provides new client program policy/system presentations.
• Coordinates and supports the resolution of client district customer concerns/issues. Consults with school district administrators to establish monetary and regulatory compliant goals to achieve maximization for their districts Medicaid reimbursement.
   

MAJOR DUTIES & RESPONSIBILITIES CONTINUED

• Acquires and maintains current program policies and criteria to ensure infrastructure operations and performs district program audits
• Coordinates with the Technology team and outside vendors to analyze and resolve issues with the on-line system through system testing and quality assurance.
• Prepares and files required reports to ensure client districts compliance with MAC quarterly claims, SHARS Cost Reports, Certification of Expended Funds (COEF) and MOE.
• Performs other job-related duties as assigned.
   

EDUCATION

Bachelor's Degree

WORK EXPERIENCE

1-3 years

SKILL AND/OR REQUIRED LICENSING/CERTIFICATION

PeopleSoft preferred, Microsoft Office, SAP preferred, Chancery preferred

Office equipment (e.g., computer, copier)

LEADERSHIP RESPONSIBILITIES

No supervisory or direct people management responsibilities. May provide occasional work guidance, technical advice and training to staff.

WORK COMPLEXITY/INDEPENDENT JUDGMENT

Work involves the application of moderately complex procedures and tasks that are quite varied. Independent judgment is often required to select and apply the most appropriate of available resources. Ongoing supervision is provided on an "as needed" basis.

BUDGET AUTHORITY

Participates in a group plan and/or budget development.

PROBLEM SOLVING

Decisions are made on both routine and non-routine matters with some latitude, but are still subject to approval. Job is occasionally expected to recommend new solutions to problems and improve existing methods or generate new ideas.

IMPACT OF DECISIONS

Decisions have minor, small and possibly incremental impact on the department or facility. Errors are usually discovered in succeeding operations where most of the work is verified or checked and is normally confined to a single department or phase of the organizational activities resulting in brief inconvenience.

COMMUNICATION/INTERACTIONS

Information sharing - gives and receives information such as options, technical direction, instructions and reporting results. Interactions are with customers, own supervisor and coworkers in own and other departments.

CUSTOMER RELATIONSHIPS

Takes routine or required customer actions to meet customer needs. Responds promptly and accurately to customer complaints, inquiries and requests for information and coordinates appropriate follow-up. May handle escalated issues passed on from coworkers or subordinates.

WORKING/ENVIRONMENTAL CONDITIONS

Work is normally performed in a typical interior work environment which does not subject the employee to any hazardous or unpleasant elements.
Ability to carry and/or lift up to 45 pounds or more.