Medicaid Program Compliance Coordinator

Medicaid Program Compliance Coordinator

Summary:

Manage the day-to-day activities of the Medicaid School-Based Services function responsible for maximizing cost recovery for the local educational authorities (LEAs) within the three-ISD consortium of Northwest Education Services, Charlevoix-Emmet ISD, Cheboygan-Otsego-Presque Isle ESD. 

This position will also provide consultation, training, and quality review of Member District billing, facilitate the resolution of billing issues and provide alignment with the Medicaid School Services Program policies to improve program compliance and to maximize cost recovery for Member Districts.

Job Qualifications

• Associate’s degree in Business, Accounting, or equivalent combination of education and experience as it pertains to finance, special education and /or Medicaid billing.
• Demonstrated skill in manipulating and analyzing data; ability to work long periods of time on preparation of detailed, analytical information.
• Ability to meet stringent deadlines and compliance requirements.
• Effective written and verbal communication skills.
• Maintain regular and reliable attendance and punctuality.
• Effective personal organization.
• Demonstrated ability to meet deadlines, as well as to organize fiscal related data.
• Positive attitude and interpersonal skills to deal effectively with staff, peers, area school personnel, and other agencies.

Preferred Qualifications:

• Bachelors’ degree in Business Administration, Public Administration or related field.  
• Five or more years of related experience.
• Knowledge of Medicaid  Services Program, Special Education, IDEA/ Medicaid, and compliance and regulations.
• Experience using  relational databases in providing data to relevant users.

Evaluation

Performance will be evaluated annually by the Directory of Finance.

General Responsibilities

• Oversee the provision of consulting services, technical assistance, and training to local educational authority (LEA) staff in interpreting the Medicaid School Services Program, Administrative Outreach Program (AOP) and Caring 4 Students policies/regulations and billing procedures, and resolution of billing issues. 
• Serve as principle liaison with ISD/ESD staff, constituent districts, and other agencies/providers related to the Medicaid Reimbursement Programs.
• Ensure ISDs/ESDs and LEAs effectively establish and implement internal controls over School  Services Program and Caring 4 Students Medicaid claims, including student eligibility, claim submission, and compliance audits.
• Facilitate communication between local business officials and special education staff in understanding the Michigan School Services Program and their role in program participation.
• Facilitate all aspects of the program quality and control systems.
• Develop, conduct and oversee the provision of professional development workshops for LEA staff on Medicaid School Services Program policies and billing procedures. 
• Prepare and oversee the preparation of program documents and reports as required.
• Coordinate all billable services (i.e. skilled nursing, psychological, speech, physical and occupational therapy, etc.) Create, maintain and provide supporting documentation and provider qualifications.
• Coordinate and develop time study training on a regular schedule.  Send reminders of time study requirements, ensure coding is accurate and reset passwords as needed.  Generate a report of staff participation, completion, and reimbursements.  Adhere to regulations and policies while tracking employees through time study to ensure 100% completion.
• Organize and analyze data and create reports to monitor and provide feedback to local districts regarding Medicaid services (e.g. volume, status, notes, compliance with policy).
• Develop and implement standard operating procedures, technologies and recordkeeping systems to improve operating quality and efficiency.
• Serve as the Consortium Schools’ primary contact to the Michigan Department of Health and Human Services (MDHHS) and other entities seeking information regarding Medicaid School Services Program function.
• Facilitate regular, ongoing communication with member district staff to provide front-line support, respond to requests and resolve issues using various print and electronic methods.
• Assist and train staff in the use of Medicaid related electronic information systems and compliance.
• Conduct Quality Assurance reviews/internal audits (quality control) regarding student records.
• Coordinate Michigan Department of Human Health Services (MDHHS) School Services Program audit for each ISD/ESD.
• Maintain current knowledge of Medicaid billing and reimbursement rules/ requirements. Implement changes to procedures as necessary.

Apply online at northwested.org under Employment Opportunities.  Applicants can include as attachments cover letter, resume and transcript(s).  Posting deadline: until filled.

Non-Discrimination Statement

Northwest Education Services and its Board of Education does not discriminate on the basis of race, color, religion, national origin, sex (including sexual orientation and transgender identity), disability, age, height, weight, marital or family status, military status, ancestry, genetic information or any other legally protected category (collectively, "Protected Classes") in its programs and activities, including employment opportunities.