Special Education Compliance / Medicaid Coordinator

Position Title: Special Education Compliance & Medicaid Coordinator

Immediate Supervisor: Executive Director of Student Services
 

Location: ELC

Summary:
The Special Education Compliance & Medicaid Coordinator is responsible for effectively and efficiently managing secretarial, administrative support, special education data, records, claims, and billing. The primary role includes management of all Special Education Data, Billing, Medicaid claims and processes. Additional responsibilities include billing for partner agencies and other responsibilities to support the efficient operation of Special Education procedures and management tasks. 

Essential Duties and Responsibilities: (Other duties may be assigned.)

• Adheres to Board policies, district procedures, and contractual obligations.
• Design, adjust, and maintain student databases for Linn-Mar residents attending special education classes outside the district.
• Verify information on contracts received from agencies/districts.
• Remain in constant contact with GWAEA/IMS to check for discrepancies in student data.
• Possess working knowledge of state special education law to maintain compliance; ensure records comply with confidentiality and due process rights laws.
• Send routine requests for copies of IEPs/progress reports to agencies/districts; check incoming IEPs for compliance; if not in compliance contact AEA or LEA.
• Calculate and process payments to agencies/districts.
• Organize and maintain student records (IEPs, contracts, progress reports).
• Verify open enrolled students.
• Design, adjust and maintain a student database for non-resident students attending special education classes in the Linn-Mar district.
• Receive calls and visitors to the office, answer questions and refer to the appropriate staff.
• Handle incoming/outgoing mail; answer routine correspondence.
• Participate in administrative staff meetings and attend other meetings or seminars.
• Perform clerical functions such as typing letters and memos, correspondence, reports, and presentations.
• Process purchase orders for the student services department.
• Type agendas for department meetings and contractual agreements for board meetings as requested.
• Make conference/hotel/travel arrangements; process expense reports/travel reimbursements.
• Collaborate with the Chief Financial Officer and Superintendent's office to compile data and help complete the Special Education Supplement of the Certified Annual Financial Report.
• Order professional materials, books, videotapes; maintain log of professional resources on loan to teachers/staff.
• Maintain files for multiple subscriptions to special education legal reference guides, journals/newsletters; verify subscription terms and process payments.
• Maintain office filing system; including board meeting minutes and confidential legal records, CAR and count information.
• Assist Executive Director of Student Services with maintenance of annual budget.
• Work closely with the business office on fund transfers and the maintenance of appropriate balances and Medicaid reimbursement.
• Compose and type billing requisitions.
• Maintain strict confidentiality and project a professional image when handling sensitive and confidential situations and information.
• Enter and compile accurate data (e.g. student information, calendars, budget, etc.) to comply with financial, legal and/or administrative requirements.
• Respond to inquiries from a variety of internal and external parties (staff, parents, students and public) to provide information and facilitate effective communication.
• Support other administrative personnel and provide assistance with administrative functions.
• Present information on administrative procedures, services, regulations, etc. to train and orient other building personnel.
• Regular and reliable attendance.
• Develops, maintains, manages and balances the Medicaid billing reimbursement program for all SPED programs. Develops procedures for Medicaid documentation and reimbursement and ensures compliance.
• Demonstrates professional and instructional leadership, models professional and ethical behavior, and maintains professional confidentiality.
• Monitors Medicaid billing data and systems for both direct and administrative claims. Submits and monitors all aspects of Medical billing, re-billing, and payments in accordance with Medicaid policies and procedures.
• Coordinates all billable services (i.e., skilled nursing, psychological, behavior, physical and occupational therapy, etc.). Creates, maintains and provides supporting documentation and provider qualifications.
• Oversees and administers Medicaid compliance programs such as time study, narrative logs, and coding issues.
• Creates procedure manuals, documentation, checklists, or guidelines as necessary.
• Prepares quarterly reports and presents information to the Executive Director of Student Services.
• Prepares weekly or monthly reports from the ACHIEVE system to the Executive Director of Student Services.
• Prepares, maintains and reviews all student Medicaid files. Ensures files meet requirements for annual audits or review.
• Prepares, maintains and reviews all special education billing, contracts, and files to ensure the district meets all requirements for annual audits or review.
• Prepares reports for the board meetings related to special education billing.
• Stays abreast of changes and developments in the Medicaid reimbursement program and attends Medicaid meetings or continuing education sessions conducted by state or federal agencies.
• Acts as district liaison with appropriate government agencies.
• Oversees all components of Medicaid claiming responsibilities, including collection and organization of claims, accurate reporting and alignment with Medicaid procedures and requirements, and submitting required claims and reports in a timely manner.
• Designs and provides training and support to administrators, nurses, teachers, associates, facilitators, and other staff involved in Medicaid claiming.
• Manages and maintains accurate special education records.
• Works collaboratively with staff at the district, building, AEA, and state level.
• Handles customer complaints and directs complaints to the proper person.
• Maintains confidentiality of sensitive data and student information.
• Completes other duties as assigned.

ESSENTIAL FUNCTIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation(s) may be made to enable individuals with disabilities to perform the essential functions.
 

• Ability to work as a member of a multi-disciplinary team.
• Ability to develop professional learning and train school personnel around Medicaid and the ACHIEVE data analysis
• Excellent written and oral communication skills including proficiency in grammar, spelling, punctuation, and related communication skills, including proofreading, editing, and creating original documents.
• Ability to work independently without supervision and as a team member.
• Ability to work under pressure with frequent interruptions, problem solve independently and with others, and take initiative.
  Ability to organize, prioritize, and assume responsibility.
• Ability to take initiative, be creative, and generate enthusiasm in others.
• Capable of representing the District in a professional manner, which includes but is not limited to confidentiality, collegiality, and the ability to obtain and utilize additional training, if necessary.

Minimum Education or Experience: 

• Bachelor's Degree
• Experience with Medicaid Claiming, ACHIEVE System, Special Education Billing
• Experience with leading change in an organization

Knowledge, Skills and Abilities: (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed here are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

Language Skills:

• Ability to read, analyze, interpret, and implement ideas contained in technical documents, assessment data, professional journals and regulations.
• Ability to effectively write reports and communications to colleagues, parents and staff.
• Ability to effectively present information orally and respond to questions from administrators, teachers, staff and students
• Demonstrated ability to use and manipulate data in Google Spreadsheets, Microsoft Excel or other spreadsheet programs.

Reasoning Ability:

• Ability to solve problems effectively.
• Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.

Mathematical Skills:

• Ability to perform basic mathematical functions.
• Ability to use spreadsheets and reporting documents that assist with the computation of data. 

Other skills and Abilities:

• Ability to establish and maintain effective working relationships with the department of education, staff, and the school community.
• Ability to speak clearly and concisely both in oral and written communication.
• Ability to perform duties with awareness of all district requirements and Board of Education policies.
• Knowledge of district policies, state and federal laws and regulations related to Medicaid program administration in education.

 Professional Standards:

1. Quality of Work (Work is correct, precise, and neat; confidentiality is maintained, as job requires; work product presents positive/professional appearance.)

2. Quantity of work (The amount of work performed is evidence of high productivity; industrious; carries fair share of work load; seeks additional tasks.)

3. Knowledge of job (The job and job-related responsibilities are well understood and reflected in job performance; exhibits continuous improvement and ongoing learning.)

4. Creativity/Problem Solving (Offers new ideas; suggests innovative and better ways of performing necessary tasks.)

5. Interpersonal Skills (Works collaboratively with others; courteous; polite; pleasant; promotes positive image in contacts with co-workers and district's customers.)

6. Dependability (Completes work in a timely fashion; reliable; punctual; consistent attendance; stable and calm in a crisis or an emergency; works independently.)

7. Professional Appearance (Dress is acceptable for the job; appears clean, well-groomed and "professional.") 

8. Organizational Skills (Exhibits ability to prioritize work; organizational skills enhance job productivity.)

9. Technical Skills (Exhibits proficiency in and uses required computer applications to maximize efficiency.)

10. Written/Verbal Communication (Convey information and ideas accurately and clearly to meet the needs of the reader, transfers thoughts and ideas into speech and presents clearly.)

11. Managing Change/ Adaptability (Demonstrates good understanding of organizational changes and communicates support for such change.)

12. Professional Approach (Professional, positive, and helpful approach with customers. Displays loyalty toward the organization. Demonstrates a capacity to understand customer (internal and external) requirements and produces a professional level of service that is satisfactory.) keyboard/mouse. Employees will sit for long periods of time. The employee is occasionally required to reach with hands and arms, stoop, kneel, or crouch. Specific vision abilities required by this job include close vision and depth perception. The employee is occasionally required to lift and/or move up to 15 pounds. A physical examination is required within 30 days of employment verifying that the employee is physically able to perform the functions of the assigned job.

Work Environment: (The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

Tobacco-free and drug-free, climate controlled working and learning environment. Noise level in the work environment is usually moderate; however, due to the number of persons working in a limited amount of space, there can be distractions. Position demands meeting deadlines with severe time restraints.

The statements in this job description are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required of personnel in this position. These statements are not intended to limit or in any way modify the right of any supervisor to assign, direct, and control the work of employees under his or her supervision.