Special Education Medicaid Specialist

Job category: Professional
Exemption Status/Test: Exempt
Reports to: Special Education Director/Coordinator
Date Revised: December 1, 2015
Dept./School: Special Education

Primary purpose

Manage SHARS (School Health and Related Services), MAC (Medicaid Administrative Claim) and RMTS (Random Moment Time Study) programs for special education services. Maintain Specialist will coordinate a high volume of data including the student claims, parent consent, and provider information; provide training to providers and monitor participation in required SHARS/Medicaid procedures; and coordinate with representative of TASB on program requirements.

Qualifications

Education/Certification

High School Diploma or GED

Valid TEA Certification

Experience

One to three years secretarial experience, preferably in public education environment

Word processing, spreadsheet, and database systems skills preferred

Customer service experience

Previous experience with insurance claims preferred

Experience in successful management of major projects

Special knowledge/skills

Ability to organize and prioritize responsibilities and projects in order to meet timelines

Ability to handle day-to-day disruptions and requirements as necessary with a positive attitude

Ability to multi-task

Ability to answer multi-line phone system

Ability to follow verbal and written instructions

Some knowledge of Special Education Services is desirable

Computer skills including use of word processing, spreadsheet and database systems

Experience in provision of training to individuals and groups

Knowledge of school district organization, operations and administrative policies

Excellent organizational, communication and interpersonal skills

 

Major responsibilities and duties

RMTS (Random Moment Time Study)

  • Conduct mandatory training sessions for teachers and teaching assistants chosen to participate in RMTS.
  • Prepare and update required participant list needed for RMTS.
  • Maintain documentation, per State requirements, showing that teachers have attended training sessions.

Manage/monitor daily responses to ensure 100% compliance with RMTS.

Training

  • Conduct training sessions with service providers regarding SHARS/Medicaid procedures and requirements involving information regarding Medicaid eligibility lists, consent forms, monitor and ensure online Medicaid session billing is completed in a timely manner.
  • Develop and revise training documents presented to teachers, team leaders, etc.

Medicaid Eligibility Lists

  • Special Education student download imported into TASB (Texas Association of School Boards) billing system.
  • Monthly eligibility list obtained from import and update billing program and special education student management system.

Consent Forms

  • Maintain record of consent forms required for any Medicaid billing.
  • Communicate with campuses information concerning consent.
  • Maintain excel spreadsheets monthly to reflect Medicaid eligible students with current consent forms.

Data Entry

  • Student Medicaid numbers and consent information entered into eStar.
  • Maintain ongoing revisions to Special Education rosters (team leaders, speech language pathologists, nurses, counselors, etc.).
  • Ensure licensure is on file as required for service providers.
  • Coordinate required prescriptions for services.
  • Enter/update student information in billing and special education information systems.

Additional State and Federal Requirements

  • R & S (Remittance and Status) Reports
  • Weekly reports indicating reimbursements
  • COF (Certification of Funds)
  • Attend required training for all State/Federal programs to earn required/current certification.

Other Requirements

  • Keep informed of and comply with all state district policies and regulations concerning primary job functions.
  • Follow all rules, regulations and policies of Garland ISD and follow directives from superiors.
  • Follow attendance policy as assigned by supervisor.
  • Perform other functions that may be assigned by the Administration/Supervisor.

Mental demands/physical demands/environmental factors

Tools/Equipment Used: 
Standard office equipment including personal computer and peripherals
Posture: 
Prolonged sitting; occasional bending/stooping, pushing/pulling, and twisting
Motion: 
Repetitive hand motions, frequent keyboarding and use of mouse; occasional reaching
Lifting: 
Occasional light lifting and carrying (less than 15 pounds)
Environment: 
Work inside, regular exposure to noise
Mental Demands: 
Work with frequent interruptions; ability to handle high volume, fast paced work load, detailed oriented, good judgment in handling confidential information, flexibility under pressure is a must

This document describes the general purpose and responsibilities assigned to this job and is not an exhaustive list of all responsible and duties that may be assigned or skills that may be required.