Account Specialist Senior - Medicaid

Account Specialist Sr. Special Education - Medicaid

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

Qualifications

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

Essential Functions

This list is illustrative only, and is not a comprehensive listing of all duties and responsibilities performed by incumbents of this class.

Duties and Responsibilities

Program coordination and compliance

• 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.

Random moment time study and data systems

• 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.

Student eligibility and consent

• 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.

Documentation review and claims

• 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.

Staff training and support

• 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.

Quarterly claiming and reporting

• 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.

Annual reconciliation and compliance reviews

• 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.

Other duties

• Perform other job-related duties as assigned.

Knowledge, Skills and Other Characteristics

• 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
• Knowledge of Microsoft Office and Google Drive Applications
• 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
• Skill in, but not limited to:
• Email
• Word Processing
• Spreadsheets
• Databases
• Presentation Software
• Accounting and basic math
• Use of standard office equipment
• Ability to effectively communicate with others.
• Ability to maintain confidential information.
• Ability to work independently in absence of supervision.

Working Conditions

General Office environment

Physical Effort

Position may require climbing, stooping, standing, walking, lifting, keyboarding, talking, listening, eye strain and repetitive motions.

May be required to travel to in and out-of-district sites.

May require lifting and carrying materials and supplies weighing up to 35 pounds

Work Year

12 months

Department/School

Special Education Department

Grade

49

Reports To

Director of Special Education

Evaluation

Classified Personnel Evaluation

Supervises

N/A

Prepared

January 2004

Revised

September 2026