Medicaid Program Assistant

GRADE: G13 (Hourly Range/Step 1 - Step 8:  $22.78- $28.09)
MINIMUM HOURLY RATE: $22.78
STANDARD HOURS PER WEEK: 40 
FTE: 1.0
MONTHS PER YEAR: 10
JOB CODE: 070714
POSITION TYPE: REPLACEMENT – PERMANENT/REGULAR
LOCATION: THORNTON, CO.  

Adams 12 Five Star Schools is deeply committed to a community of excellence, equity, and inclusion in everything we do. We commit to eliminate the predictability of who is included in excellence and who is not. Adams 12 Five Star Schools puts students first and supports our district's mission to elevate student success for every student every day in every classroom. Candidates who can contribute to our goal are encouraged to apply and to identify their strengths in this area.

SUMMARY:  Responsible for assisting the Medicaid department by providing varied and complex support through database administration, compliance, customer service, and training. Accountable for quality assurance of department data, billing, and documentation to the state.
 
ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  Frequency and percentage of time may vary based on assignment.

1.  Verify and update all three state Medicaid eligibility, documentation and claiming websites. Verify and update district managed student information and IEP databases. Maintain student information to facilitate direct service provider documentation and management of their caseloads in the state documenting website. Maintain all student files for future review and audit by the state of Colorado.
2.  Monitor and ensure maximum response to the federal mandated Random Moment Time Study, ensuring a minimum compliance rate of 85% through the state monitoring website.
3.  Collaborate with coordinator to assist with training and support through the district for SPED teams and providers of Medicaid-related care as it relates to appropriate documentation of reimbursable services. Ensure accuracy with documenting and maximize the process efficiently.
4.  Maintain a tracking process to ensure Medicaid documentation and claiming is completed accurately, timely, and in compliance with the Colorado School Health Services Medicaid policies and regulations. Analyze data received from the state regarding quality assurance and submission review reports.
5.  Serve as the subject matter expert on the ezEdMed system and provide technical assistance to employees.
6.  Track and accurately monitor confidential department licensing requirements for providers on direct service Medicaid roster using the CDE, DORA, and ASHA websites. Maintain, review, and update Medicaid one-time parent consent forms for all students. Review student IEPs for language compliance according to state guidelines. Monitor nurse delegation records for documentation and compliance with IEP services. Assist coordinator in the maintenance of a variety of confidential accounts, including gathering documentation for state program reviews/audits.
7.  Communicate with Health Care Policy and Financing (HCPF), Colorado Department of Education (CDE), and the Adams 12 Medicaid reimbursement program billing agent to develop, maintain, and monitor compliance with the School Medicaid Reimbursement Program rules and regulations. Attend all HCPF, CDE, PCG, Consortium and department trainings/meetings throughout the year.
8.  Collaborate and maintain a positive working relationship with the Grant Account assigned to the Medicaid Program. As requested by the Grant Accountant, provide information necessary to complete financial reporting and reconciliation tasks.
9.  Assist the Medicaid Coordinator with coordination, membership, and meeting minutes for the local advisory committee and implementation team.
10. Perform other job-related duties as assigned.

EDUCATION AND RELATED WORK EXPERIENCE: - Associates Degree or equivalent preferred.  High School Diploma or equivalent required.
- Courses in business or vocational school in business administration, budgets/accounting, office management equivalent to one year of college. Additional relevant related experience may be substituted for this educational requirement.
- Must be a minimum of 18 years old.
-  Minimum of five years of experience in clerical and office support.

LICENSES, REGISTRATIONS or CERTIFICATIONS
- Criminal background check required for hire.

APPLICATION INFORMATION: 
All applicants (current district employees and external applicants) should list any and all work experience, including current district experience, when completing the employment application.  Please include job titles and duties that you held while doing that job.  Since the Human Resource department uses the application to screen for minimum qualifications required for each job, it is important to have a complete application so you will be considered for the position you are applying for.

SALARY INFORMATION: 
All Classified positions are paid on an hourly basis.  All Newly hired classified employees are placed initially on Step 1 of the pay grade for their position. Classified employees can advance an additional 7 steps (maximum Step 8) based on their previous experience.  Final hourly placement on the Classified Salary schedule is dependent on the Grade Level for the position being posted and employees’ previous work experience. “Grade” refers to position or job classification and “Step” refers to the number of work experience credit or service years. See our Classified Salary Schedule for hourly rates. For additional compensation information, please refer to The Classified Master Agreement.
 
BENEFITS INFORMATION: 
Adams 12 Five Star Schools is committed to providing an environment that promotes a healthy employee population able to serve our students at the highest level. We offer a comprehensive benefits package including medical, dental, vision and life insurance as well as other programs for benefit eligible employees. The employee assistance program, voluntary life insurance through PERA, and 401(k), 403(b) & 457(b) plans are available to all employees regardless of hours worked and are available immediately (upon hire date).  To learn more about our benefits, please see our Benefits Overview.

THIS POSTING IS NOT INCLUSIVE OF THE JOB DESCRIPTION.
Rev 10/24