Account Specialist Senior Medicaid

CATEGORY: Classified

TITLE: Account Specialist Sr. Special Education - Medicaid

JOB DESCRIPTION:

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

QUALIFICATIONS :

1. Education and/or experience equivalent to a High School Diploma or GED
2. Three (3) years administrative support experience preferably in a human resources department
3. State of Arizona Identity Verified (IVP) Fingerprint Clearance Card
4. May require a valid Arizona Drivers License

ESSENTIAL FUNCTIONS :
(Essential functions as defined under the Americans with Disabilities Act may include any of the following tasks knowledge skills and other characteristics. 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 districts 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 customer service/public relations practices and procedures
• 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

Required Experience:

Senior IC