Paradise Valley Unified School District No. 69

 

MEDICAID CLAIMS TECHNICIAN (previously Medicaid Claims Specialist)

 

QUALIFICATIONS:

1. Associate of Arts Degree or equivalent.

2. Three years of experience in an Accounts Payable or other double entry bookkeeping system.

3. Experience with Microsoft Office products.

4. Effective communication with office and professional staff delivering services eligible for Medicaid reimbursement.

 

PREFERRED QUALIFICATIONS:

1. Experience with Federal and State reporting of financial information.

2. Experience with medical billing software.

 

REPORTS TO: Director of Finance and Budget

 

SUPERVISES:  Clerk II

 

GRADE: 21

 

ESSENTIAL JOB FUNCTIONS:

  1. Establish and maintain a good rapport with students, employees and community
  2. Coordinate and administer Medicaid programs within the district.
  3. Maintain current knowledge of state guidelines for Medicaid programs.
  4. Act as liaison person for the Medicaid programs.
  5. Provide training for District provider relating Medicaid programs.
  6. Review coding of staff in employee management system to ensure accurate reporting for Medicaid reimbursement.
  7. Prepares outreach claims on a quarterly basis.
  8. Identify and enroll qualified staff as AHCCCS providers for the Medicaid programs.
  9. Maintain provider database for renewal dates, renewal fees, and license numbers.
  10. Maintain all required detailed information from qualified providers of Medicaid services.
  11. Consult with district providers on medical record keeping of data collection.
  12. Identify and enroll eligible students in the Medicaid program.  Notify providers as needed.
  13. Compile & review provider data collection sheets into a claim for submission to third party processor.  Monitor claims for accuracy and compliance with Medicaid guidelines.
  14. Monitor the amount of dollars received from the Medicaid fund.
  15. Follow up on claim payments due to the district.
  16. Maintain confidentiality when dealing with student and district provider information
  17. Other job related duties as assigned.

 

TERMS OF EMPLOYMENT: Twelve month work year.  Salary and annual work year to be established by the Board.

 

EVALUATION: Performance will be evaluated in accordance with provisions of the Board’s policy on Evaluation of Support Employees.

 

ADA ACCOMODATIONS: Decisions regarding appropriate and reasonable accommodation(s) will be based on the merits of each situation. The principle criteria will be that of effectiveness.

 

SKILLS TESTS REQUIRED:  Mathematics

 

Revised: 7/1/03; 7/1/05