Specialist, SHARS/Medicaid

Primary Purpose: Maintain and support School Health and Related Services (SHARS) and Medicaid Administrative Case Management (MACM) claims, training and reimbursement for specialized services as outlined by federal and state guidelines. RESPONSIBILITIES: Major Responsibilities and Duties

• Act as primary secretary for program coordinator.

• Place and receive telephone calls and accurately record messages.

• Assist with translating in person and over phone, if bilingual.

• Process routine travel/mileage for department administrators.

• Provide RMTS Trainings and SHARS/MAC trainings.

• Manage electronic software for Medicaid reimbursement.

• Manage relational data base of case information.

• Monitor submissions and provide follow up/reminders.

• Review incoming claims for SHARS and Medicaid services to ensure they align with regulatory procedures.

• Generate tickets related to billable services.

• Maintain accurate records related to claims for audit purposes.

• Function as a liaison between service providers, parents and contract vendors.

• Provide training for individuals participating in SHARS and Medicaid programs.

• Review prescriptions for students receiving nursing, occupational and physical therapy services.

• Work with various departments whose staff members provide billable medical, counseling (LSSP) and transportation services to ensure logs are generated and tickets submitted.

• Track and facilitate data entry to ensure that the district claims are billable services.

• Reconcile reimbursements with claims and allowable services.

• Anticipate potential billable areas and introduce plans to exploit.

• Attendance at work is an essential function.

• Perform other duties as assigned.

Do you have a valid Driver's License license?, Do you have experience in Regulatory compliance in claims processing?, Do you have a High school diploma or GED?, Minimum Education/Certification:

• High school diploma or two years of college preferred
• 30 college credit hours or three years of experience as a secretary or similar office experience
• Valid Texas driver's license
• Eligible for coverage under the district's vehicle insurance program

Special Knowledge/Skills:

• Ability to maintain accurate records, establish and keep deadlines, and organize SHARS/Medicaid data
• Ability to use SHARS and accounting software
• Strong skills in written and oral communication
• Knowledge and/or ability to learn state and federal regulatory policies and procedures related to SHARS and Medicaid
• Working knowledge of general special education and OT/PT terms and program services
• Working knowledge of how to classify and organize Medicaid information
• Consultation skills for working effectively with all levels of staff
• Ability to prioritize and distribute special education materials based on date received and time lines

OTHER INFORMATION: Working Conditions: Mental/Physical Demands/Environmental Factors: Light lifting and carrying (under 20 pounds), repetitive hand movements and extended use of computer, able to see and hear within normal range. Maintain composure under stress, able to work in distracting and stressful environments, able to work with interruptions, able to manage tasks with deadlines and financial ramifications, able to provide transportation, in and out of district travel. JOB CONTACT INFORMATION

Wage/Hour Status: Hourly; Reports To: Director of Special Education; Date Revised: October 2018 SALARY: Pay Grade: 5 DAYS: 210