Job Specification Details

Administrative and technical work involved in billing Medicaid for school-based health services provided by Vermont school districts. Work involves acting as a technical expert for the program to a group of supervisory unions and schools. There is considerable interaction with a wide variety of people including school personnel, Medicaid clerks, and medical providers. Work requires significant travel to school and supervisory union locations throughout the assigned region and to meetings with the State. Employee may work from a home office. Work is performed under the general supervision of the Unit supervisor.

Provides technical and program expertise to facilitate, train, and assist the supervisory unions in billing appropriate special education services for students enrolled in Medicaid for Medicaid reimbursement. This involves training Medicaid Clerks, case managers and service providers on all aspects of the program including the billing and documentation requirements for the program. The specialist monitors claims activities for their assigned supervisory unions and assists in resolving issues concerning claims submission. Work also involves auditing records for claims submitted to ensure that all the proper federal and state documentation is maintained by the school districts to support the claims. Specialists provide input for program manual revisions and participate in statewide training efforts. Provides input and feedback on form development and implementation to make sure program requirements are consistent across different regions of the State. Work requires meeting with each Medicaid Clerk at their location on a monthly basis. Additionally, interacting with and providing feedback to the Special Education Director on the operation of the Medicaid billing process for their assigned supervisory union. Performs related duties as required.

Duties are generally performed in a standard office setting but there will be significant travel required for which private means of transportation must be available. Some work may be required outside of regular work hours. In dealing with a wide variety of people and groups, diverse and strongly held opinions may be encountered.

Interpersonal skills and relationship building. Ability to stay positive in tough and difficult situations.

Ability to understand, interpret and apply state and federal regulations and directives pertaining to Medicaid and health care providers.

Ability to self-motivate and organize multiple information streams from a variety of sources.

Ability to develop, organize and deliver training.

Ability to communicate effectively, both orally and in writing.

Ability to establish and maintain effective working relationships.

Ability to enforce regulations firmly and with tact.

Knowledge of modern office practices including computer programs for word processing, several various databases and maintenance of complex spreadsheets.

Ability to operate effectively in a virtual setting. Including but not limited to setting up, facilitating, and communicating over virtual platforms. Ability to review, edit and upload documents in a shared virtual environment.

Two (2) or more years of full-time college coursework in business, accounting, education, human services administration, or related field.

OR

Three (3) or more years of experience in accounting, healthcare, billing, business administration, or related field.

Experience with Medicaid or insurance billing. 

n/a