Medicaid Compliance Coordinator

Marquette, MI
Full Time
Mid Level

POSTING DATE: July 3, 2024

 

JOB POSTING

Medicaid Compliance Coordinator

SUMMARY

The Medicaid Compliance Coordinator is the main liaison for Medicaid reimbursable programs and services, ensuring compliance with Federal and State laws. Key duties include preparing/submitting Medicaid-related reports, monitoring costs, coordinating financial reports, establishing internal controls, and using systems like PCG and bhworks for billing. The Coordinator provides assistance to RESA and local district staff, facilitates training opportunities related to school-based Medicaid programs/services, improves program compliance, and verifies accuracy of billing/invoices.
 

MINIMUM QUALIFICATIONS: 

  • Bachelor’s degree in accounting, finance, public administration, business administration, or related field.
  • Five years of experience related to Medicaid service programs, Medicaid billing, IDEA, special education, compliance, regulations, and/or use of relational databases 
  • Demonstrated ability to:
    • Organize short and long term projects
    • Establish and maintain filing systems (physical and electronic)
    • Problem-solve and apply principles of logical thinking
    • Accurately complete fiscal procedures (e.g., billing Medicaid reporting)
  • Proficiency with software/applications including Microsoft Word, Excel, PowerPoint, Google Suite, and Zoom
  • Excellent filing and organizational skills
  • Strong verbal and written communication skills
  • Must demonstrate initiative and the ability to work independently
  • Professional attitude and appearance
 

PREFERRED QUALIFICATIONS:

  • Experience with Public Consulting Group systems such as EDPlan
  • Familiarity with the use of bhworks software
  • Working knowledge of the Caring 4 Students (C4S) program
  • Strong accounting or finance background
 

ESSENTIAL DUTIES AND RESPONSIBILITIES:  

  • Serve as principal liaison with RESA staff, constituent districts, and other agencies/providers related to Medicaid reimbursable programs and services
  • Monitor all aspects of Medicaid-related costs reported by the Agency and LEAs to ensure costs are reasonable, allocable and allowable under Federal and State laws and regulations
  • Coordinate and file Medicaid-related financial reporting for the RESA for all billable services (e.g.,  psychological, speech, physical therapy)
  • Establish/implement internal controls over Medicaid claims, including student eligibility, claim submission, and audits
  • Utilize Public Consulting Group (PCG) and bhworks systems for Medicaid billing and to ensure compliance
  • Assist and train staff in the use of Medicaid-related electronic information systems and compliance
  • Provide support to RESA and local district staff with the use of EDPlan and bhworks
  • Support Caring 4 Students (C4S) initiatives and reporting obligations; compile/submit the RESA’s quarterly staff pool lists; and assist local districts with their quarterly staff pool lists
  • Distribute and assist RESA and LEA staff with monthly Medicaid error reports 
  • Develop, conduct and oversee the provision of professional development workshops for LEA staff on Medicaid policies and billing procedures for school-based services
  • Prepare and oversee the preparation of program documents and reports as required
  • Create, maintain and provide supporting documentation and provider qualifications
  • Lead efforts to improve program compliance and maximize cost recovery for the Agency and LEAs
  • Verify payment of invoices associated with Medicaid-related programs, services and distributions 
  • Organize/analyze data and create reports to monitor and provide feedback to local districts regarding Medicaid services (e.g. volume, status, notes, compliance with policy)
  • Develop and implement standard operating procedures, technologies and recordkeeping systems to improve operating quality and efficiency; implement changes to procedures as necessary
  • Review procedures and prepare internal audit reports in compliance with state, federal, and local policy
  • Monitor program and financial compliance with Medicaid billing requirements; initiate  corrective action as needed
  • Reconcile accounts and research / resolve billing discrepancies
  • Serve as primary contact with the Michigan Department of Health and Human Services (MDHHS) and other entities seeking information regarding Medicaid-related services and programs
  • Facilitate regular, ongoing communication with district staff to provide front-line support, respond to requests and resolve issues
  • Maintain current knowledge of Medicaid billing and reimbursement rules/requirements. Implement changes to procedures as necessary
  • Facilitate communication between local business officials and special education staff regarding programs and services that are Medicaid eligible
  • Present at Special Education Coordinator meetings and Principal meetings on school-based Medicaid programs and upcoming deadlines as requested
  • Provide outside auditors with assistance; gather necessary information/documents to support Medicaid audits
  • Attend meetings and professional workshops as needed to enhance skills, knowledge, and Agency procedures
  • Perform other duties as assigned
 

OTHER KNOWLEDGE, SKILLS, AND ABILITIES:

  • Demonstrated experience exercising confidentiality and sound judgment in dealing with local districts, staff, students, and operations
  • Ability to work on multiple projects and maintain proactive communication with stakeholders
  • Ability to deal with issues in a fair manner, treat diverse populations and personalities with dignity and respect, and act in a highly ethical manner
  • Ability to work in a fast-paced environment yet maintain flexibility in thinking and actions
  • Detail-oriented with strong analytical skills; highly skilled with Excel and/or Google Sheets
 

SPECIAL CONDITIONS:

  • Perform position duties and functions while upholding confidentiality of privileged and sensitive information
  • Must consistently perform duties and functions thoroughly, accurately, and with strong attention to detail


TERMS OF EMPLOYMENT: Full time; 12-month position; non-union; Must have regular and reliable job attendance, performance, and the physical ability to do the job

 

REPORTS TO: Director of Special Education Accountability & Compliance

COMPENSATION: Salary range of $65,237-$80,234; compensation includes a full benefits package 

APPLICATION DEADLINE: 12 p.m. on Wednesday, July 17, 2024

 

Apply online at https://www.maresa.org/employment/

Please direct any questions to [email protected]

Marquette-Alger Regional Educational Service Agency does not discriminate on the basis of race, color, national origin, sex, (including sexual orientation and gender identity), disability, age, religion, height, weight, marital or family status, military status, ancestry, genetic information, or any other legally protected category, (collectively, "Protected Classes") in its programs and activities, including employment opportunities. The Agency's Compliance Officer shall handle inquiries regarding the Board's nondiscrimination policies and address any complaint of discrimination.
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