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Medicaid Administrative Claiming Representative

  • 513430
  • PHOENIX
  • TUCSON
  • SCHOOLS FOR THE DEAF AND THE BLIND
  • Full-time

SCHOOLS FOR THE DEAF AND THE BLIND

Delivering results that matter by providing best in class support services.

Medicaid Administrative Claiming Representative

SCHOOLS FOR THE DEAF AND THE BLIND

Job Location:

Address:  1200 W Speedway Blvd, Tucson AZ 85745 or 7654 N 19th Ave, Phoenix, AZ 85021

Posting Details:

Salary: $17.39-$22.09 

Grade: 10

Closing Date: Open Until Filled

Job Summary:

CLASS SUMMARY
 The Medicaid Administrative Claiming (MAC) Representative receives supervision and work assignments from the Director of Business Services (or designated supervisor).

The position is responsible for all functions related to the Medicaid reimbursement programs for school based services, the the Direct Service Claiming (DSC) program and the Medicaid Administrative Claiming (MAC) program. The position serves as the primary point of contact for all Medicaid program activities. The essential duties include, but are limited to the following:

• Develops, maintains, manages and balances the Medicaid billing reimbursement program for all special education 
  programs. 
• Develops procedures for Medicaid documentation and reimbursement and ensures compliance.
• Monitors Medicaid billing data and systems for both direct and administrative claims.
• Submits and monitors all aspects of Medical billing, re-billing, and payments in accordance with Medicaid policies and 
  procedures. 
• Identifies Medicaid-eligible students and implements procedures for ongoing identification and verification of eligibility.
• Coordinates all billable services (i.e., skilled nursing, psychological, speech, physical and occupational therapy, etc.). • Creates, maintains and provides supporting documentation and provider qualifications.
• Monitors and maintains payment systems in order to obtain maximum revenue.
• Trains agency personnel in Medicaid requirements, procedures, and compliance, including Medicaid eligibility lists, 
  consent forms, billing session notes, etc.
• Oversees and administers Medicaid compliance programs such as time study, narrative logs, and coding issues.
• Sends reminders of time study requirements, ensures coding is accurate and resets passwords as needed.
• Generates report of staff participation, completion, and reimbursements. Adheres to regulations and policies while 
  tracking employees through time study to ensure 100% completion.
• Coordinate with the Payroll Department to complete and submit the quarterly and annual certification of funds.
• Stays abreast of changes and developments in the Medicaid reimbursement program and attends Medicaid meetings 
  or continuing education sessions conducted by state or federal agencies.
• Coordinates with other school districts or outside agencies to resolve problems or situations for Medicaid 
  reimbursement and information about eligible students.
• Performs other duties as assigned.

TRAINING AND EXPERIENCE:
 
Required education: High school diploma or G.E.D

• Proficient with Microsoft Word, Excel and Outlook
• Effective verbal, listening, and written communication skills.
• Proficient in data entry.
• Ability to work as a team player with many different levels of personnel as well as 
  ability to work well under pressure.
• Three years of experience or knowledge of special education and related services.
• Experience working with the PCG Claiming System preferred.

LICENSING/CERTIFICATION REQUIREMENTS:
Must be able to pass FBI and State background check
Defensive Driver Training Program to be completed by all agency personnel that driveon State business
KNOWLEDGE OF:
?• Policies, procedures, and programs of the immediate work unit
• Principles and practices of administration and management
• Agency or program rules, regulations, and operating procedures
• Administrative and clerical procedures, managing files and records.
• Appropriate channels of communication.
• Knowledge of policies and procedures related to Medicaid Administrative Claiming 
  and Direct Service Claiming programs.
• Knowledge of mathematics and statistics.
• Detail oriented and ability to meet established deadlines

 
DEMONSTRATED SKILL/ABILITY TO:

• Communicate information and ideas effectively so that others will understand.
• Analyze and compile information. 
• Apply a logical thought process necessary for problem solving and decision making.
• Research and reconcile documents for report preparation and maintain files and 
  documents necessary for audit.
• Organize and prioritize.
• Attention to detail and accuracy.
• Develop and maintain a great working relationship with agency staff and contracted 
  providers and maintain confidentiality.
• Apply policies and procedures. 
• Use of office equipment and computers including various office programs (i.e. Word, 
  Excel, Outlook, etc.)

Job Duties:

 

Knowledge, Skills & Abilities (KSAs):

 

Selective Preference(s):

 

Pre-Employment Requirements:

 

Benefits:

The Arizona Department of Administration offers a comprehensive benefits package to include:
Sick leave
Vacation with 10 paid holidays per year
Health and dental insurance
Retirement plan
Life insurance and long-term disability insurance
Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Retirement:

 

Contact Us:

If you have any questions please feel free to contact Leo Valenzuela at Leonardo.Valenzuela@asdb.az.gov or 520-770-3245 for assistance.

ARIZONA MANAGEMENT SYSTEM (AMS)

All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress.  Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results.  
State employees are highly engaged, collaborative and embrace a culture of public service.

The State of Arizona is an Equal Employment Opportunity Employer.