Manage the daily operations of the department including the planning and organizing of Medicaid Coordination Services operations, systems and program compliance for the district's School Health and Related Services (SHARS) Program, Medicaid Administrative Claiming (MAC) Program, and Medicaid/CHIP Outreach Enrollment Program Initiatives.
Establish and ensure efficient and effective systems in collection of student sessions, documentation, and Random Moment Time Study requirements for reporting and submitting SHARS claims for recoupment of funds to the district.
Coordinate and direct the development and production of technical assistance to teachers and other personnel responsible for reporting data used for claims reimbursements. Manage and deliver training required for program participation.
Manage Remittance and Status (R&S) reports with reimbursement deposits from Texas Medicaid & Healthcare Partnership (TMHP) - Medicaid Claims Administrator Texas.
Manage and/or create monthly and periodic analyses for R&S reports reconciliation for SHARS revenue by service codes.
Manage the MAC time study process; implement quarterly time study participant training.
Work with Human Capital Management and assist in the maintenance of all employees with State Board issued licensures and certifications with annual expirations. Maintain internal records for the district service providers' certifications and/or licensures.
Prepare, analyze and maintain quarterly Medicaid Administrative Claiming Financial Reports, including establishment of Indirect Cost Pool and Cost Settlements to generate annual revenue at approximately $800,000.00.
Prepare, analyze, and maintain the collection of data from various sources to compile the annual SHARS Cost Settlement and Reconciliation Report for submission to Health and Human Services Commission (HHSC) for an annual reimbursement of $20,000,000.00 in revenue to the district.
Track, audit and review all quarterly MAC Financials and Annual SHARS Cost Reports submitted to HHSC for recoupment of funds.
Keeps abreast of technical, legislative, and professional trends and developments affecting Medicaid at the local, state, and federal levels; communicate changes and updates to appropriate district personnel.
Maintain an extensive network and excellent working relationships with campus principals and staff throughout the district to promote community outreach and enrollment activities for enrolling students into the Medicaid/CHIP program.
Monitor staff and systems to maintain the confidentiality of student and staff records; comply with all HIPAA and FERPA guidelines and regulations.
Performs all other tasks and duties as assigned.
Bachelor's Degree required; Texas Association of School Business Officials - RTSBA Certification preferred
Three years of school business experience and two years medically related experience
Experience in health care billing, Medicaid, SHARS, and special education
Knowledge of special education programs and procedures
Knowledge of school-based Medicaid programs
Effective in compiling, organizing, and managing data for administrative and operational effectiveness
Ability to identify and define problems and solutions
Skilled in initiating, structuring, and carrying out steps to complete project and tasks
Effective in teaching individuals or groups by conveying information using multiple techniques, methods, and technologies
Excellent computer skills with knowledge of MS Windows, ORACLE and APEX
Dallas Independent School District