Medicaid Clerk

Medicaid Clerk

FLSA Status: Non-Exempt

Reports To: Director of Exceptional Education

Supervises: None

Employment Terms: Part-time Position (500 Contracted Hours per Year)
Subject to change based on Medicaid requirements

Grade: Hourly


Position Summary


The Medicaid Coordinator serves as the primary liaison between the school division and the Virginia Department of Medical Assistance Services (DMAS). The primary goal is to maximize federal reimbursement for health-related services provided to students while ensuring strict adherence to state and federal regulations. In addition, this individual must be able to compile data into presentations and reports in a timely manner to inform the Director of Exceptional Education regarding school Medicaid program outcomes.


Qualification Requirements


To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below 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.

Essential Functions

1. Oversee and manage the submission of Medicaid claims for eligible services in collaboration with division administration.
2. Reconcile student enrollment data with DMAS eligibility files to identify and maintain an accurate roster of billable students.
3. Monitor, track, and verify Medicaid reimbursements to ensure the division receives maximum allowable funding.
4. Maintain and update provider participation lists quarterly, ensuring compliance with all licensure requirements and DMAS regulations.
5. Review and audit provider documentation to ensure compliance with DMAS requirements, state regulations, and local policies.
6. Develop and deliver communications, reports, procedural guides, and training materials to support and strengthen the division's Medicaid program.
7. Utilize student information systems effectively, demonstrating proficiency in data entry, data management, and reporting processes.
8. Establish and maintain collaborative relationships with Medicaid billing vendors, the Virginia Department of Education (VDOE), the Department of Medical Assistance Services (DMAS), and the University of Massachusetts Chan Medical School (UMass Chan) to ensure compliance with all Medicaid billing requirements.
9. Develop, implement, and monitor procedures related to Medicaid reimbursement, administrative claiming, transportation billing, and other assigned initiatives.
10. Collect, manage, and audit Medicaid-related data, including reviewing service provider logs and coordinating with staff responsible for billing submissions.
11. Stay current on Medicaid laws, regulations, and federal/state guidelines; interpret and apply policies to ensure program compliance.
12. Collaborate with Finance, Transportation, and Student Information staff to complete and submit required reports, including quarterly reporting.
13. Participate in required training and professional development related to the school Medicaid program.
14. Perform other duties as assigned by the Director of Exceptional Education.

Knowledge, Skills and Abilities

1. Training in Microsoft Office Suite is preferred.
2. Must possess excellent oral and written communication skills and organizational skills.

Qualifications, Education and Experience

1. High School Diploma or equivalent
2. Must have experience working with Microsoft Office Suite, in particular with Excel.
3. Such alternatives to the above qualifications as the School Board may find appropriate and acceptable.

Physical Requirements

1. May require occasional exertion of up to 10-25 pounds of force to distribute educational materials/items and using technical equipment in area of assignment.
2. Work has standard vision requirements; visual inspection involving small defects and/or small parts.
3. Hearing is required to perceive information at normal spoken word levels and to receive detailed information.
4. Requires preparing and analyzing written or computer data.
5. Must be physically able to operate a motor vehicle or equipment and be mobile enough to travel and monitor all aspects of the school program in the settings within area of assignment.

Special Requirements

1. All candidates must successfully undergo the following pre-employment screenings:
1. Tuberculosis Screening
2. Child Protective Services (CPS) Investigation
3. State Police Criminal History Investigation

Evaluation

Performance of this position will be evaluated in accordance with the provisions of the Dinwiddie County School Board's policy manual.

Equal Opportunity Employer Statement


As an Equal Opportunity Employer, Dinwiddie County Public Schools does not discriminate against applicants on the basis of race, color, religion, national origin, ancestry, political affiliation, sex, sexual orientation, gender, gender identity, age, marital status, genetic information, disability or protected veteran status.


We will recruit and select applicants for employment solely on the basis of their qualifications. Our guidelines and practices, including those relating to wages, benefits, transfers, promotions, terminations and self-development opportunities, will also be administered without regard to race, color, religion, sex/sexual orientation, gender/gender identity, age, marital status, genetic information, national origin, ancestry, political affiliation, disability, protected veteran status and all other classes protected by the Federal and State Law. Dinwiddie County Public Schools is a Drug & Alcohol Free Workplace.