Medicaid Reimbursement Specialist

DEFINITION:

Under close supervision, assists and supports a specific District approved program budget for Sunnyside Unified School District.

ESSENTIAL FUNCTIONS

(Essential functions, as defined under the Americans with Disabilities Act, may include the following tasks, knowledges, skills and other characteristics. This list of tasks is ILLUSTRATIVE ONLY, and is not a comprehensive listing of all functions and tasks performed by positions in this class).

TASKS

Maintains the District's medicaid compliance with program requirements; provides backup documentation for all financial data and service claim submittals; tracks student participation in the program; identifies student caseloads by provider and by school to verify that all eligible students and included in the claiming process; coordinates all aspects of the random moment time study surveys (RMTS) including updating and certifying the staff pool listing quarterly, requesting new email addresses and password resets, monitoring website for response compliance, and providing training;

Provides staff training in procedures and documentation requirements; schedules quarterly CPR/ first aid classes for Health Aides; coordinates compliance audits; prepares and submits monthly billing statements in accordance with policies; develops and maintains student and provider databases for medicaid programs; tracks program-related staffing costs for reimbursement; verifies certifications and parent consent forms; maintains and files paperwork; coordinates all pragmatic reporting; performs related duties as assigned.

KNOWLEDGE, SKILLS AND OTHER CHARACTERISTICS

• Knowledge of State and Federal rules, regulations and laws governing medicaid reimbursement.
• Knowledge of District and Department policies and procedures.
• Knowledge of Special Education Program policies and practices.
• Skill in the use of a personal computer.
• Skill in preparing letters and reports.
• Skill in following oral and written instructions.
• Skill in establishing and maintaining effective working relationships.

PHYSICAL REQUIREMENTS:

Work is performed in an indoor environment. Work requires frequent sitting, bending, repetitive motion, attention to detail, may require some lifting.

QUALIFICATIONS

• High School Diploma or equivalent
• Two (2) years of accounting experience, business experience, or an equivalent combination of training and experience. Additional certifications may also be required as specified by the District.

PREFERRED QUALIFICATIONS:

Associate's Degree in Business Administration or related field.

Depending on the needs of the District, some incumbents in this class must be able to demonstrate fluency in both Spanish and English as a condition of employment.

SALARY GRADES

Salary Grade: K Hourly Pay: $22.00 Hours per Day: 8 Days in Contract: 260