Job description

Position Title: Medicaid Billing Specialist

*
Pay Grade: 15 Period* of Employment: 12 months

*
Description* Approved/ Revised: 7/2022 FLSA Status: Non-Exempt

*
Supervised* by and/or Reports to: Supervisor of Accounting and Grants Management

*
General Responsibilities*: Performs a full range of tasks including collaboration, documentation and reporting, in support of the Manassas City Public Schools’ Medicaid and Schools program.

*
Essential Duties:*
(This list is intended solely as an illustration of the various types of work performed. The omission of specific duties does not exclude their addition if they are similar to or a logical extension of the position.)

*
Reviews, calculates, and processes monthly provider services for Medicaid reimbursement through Virginia Department of Medical Assistance Services (DMAS) portal.

• Audits and verifies all billable Medicaid services are properly documented and submitted timely to DMAS.
• Reviews electronic DMAS remittance advices, reconciles submissions to payments, and follows up on denied claims. Submits adjustments as needed.
• Troubleshoots issues with billing software and makes recommendations for improvements to streamline processes.
• Maintains electronic and paper student Medicaid files.
• Maintains confidentiality of student eligibility and records in accordance with applicable HIPAA and FERPA regulations.
• Tracks, analyzes, and interprets reports and data generated by third party Medicaid billing process. Works with providers to resolve issues and ensures timely completion of documentation.
• Responds to provider inquiries regarding billing software and Medicaid documentation requirements
• Coordinates all billable services including but not limited to personal care, skilled nursing; psychological, speech, physical and occupational therapy services and Creates, maintains, and provides supporting documentation and provider qualifications.

*
Verifies providers maintain current licensure, certifications, NPI and ORP as required by regulations.

• Creates, maintains, and submits Random Moment Time Study (RMTS) calendars, work schedules, and participant lists.
• Coordinates and trains providers on Submits personnel changes to maintain current list of school providers.
• Trains providers on use of Medicaid billing system and requirements for billing compliance.
• Compiles documentation and data for compliance reviews related to Medicaid audits and annual reconciliations.
• Stays abreast of changes and developments in the Medicaid reimbursement program and attends Medicaid meetings conducted by state
• Develops and maintains internal procedures pertaining to Medicaid documentation and reimbursement ensuring compliance with applicable state regulations.
• Manages the Emergency Care & Safety Institute (ECSI) and CPR Frontline Professional Development Growth Systems.
• Collaborates with Finance, Special Education, Health Services, and Transportation Departments to obtain information on Medicaid-related activities as needed for Cost-Based
• Performs other duties as

*
Requisite Knowledge, Skills, and Abilities:*

*
Strong analytical and problem-solving skills.

• Detail-oriented with strong organizational skills
• Proficient in Excel, Word and Outlook.
• Ability to work independently.
• Able to communicate effectively both orally and in writing.
• Ability to establish and maintain effective working relationships

*
Requisite Education and Experience:*

*
Must possess a high school diploma or equivalent (GED); an Associate’s degree in accounting or business

• Knowledge of principles, methods, and practices of Medicaid account billing
• Five (5) years’ experience in a detailed work environment.
• Basic accounting knowledge or skills helpful.

*
Physical Requirements:*

Must have the use of sensory skills in order to effectively communicate and interact with other employees and the public through the use of the telephone and personal contact as normally defined by the ability to see, read, talk, hear, handle or feel objects and controls. Physical capability to effectively use and operate various items of office related equipment, such as, but not limited to: a personal computer, calculator, copier, and fax machine. Some climbing, stooping, kneeling, crouching, reaching, standing, walking, pushing, pulling, lifting, grasping, or repetitive motions required.

Manassas City Public Schools assures equal employment opportunities and equal education opportunities for employees and students as required by federal and state orders and laws. Reasonable accommodations may be made to enable individuals with disabilities to perform essential tasks.

_
This job description is intended to accurately reflect the position activities and requirements. It is neither intended to be, nor should it be construed as, an all-inclusive list of the responsibilities, skills, or working conditions associated with the position. The administration reserves the right to modify, assign, or remove duties as necessary_

Job Type: Full-time

offroadmanagementgroup.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, offroadmanagementgroup.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, offroadmanagementgroup.com is the ideal place to find your next job.