The WISD's Mission is to educate, serve, and advocate with students, families, schools and the community. We disrupt racial inequities, build just educational systems, and expand access for all learners. We value human potential while striving to support current and future generations of Washtenaw County to enrich as many lives as we possibly can.

The WISD’s Vision is to be a leader in empowering, facilitating, and delivering high‐quality, boundary spanning, educational system that educates all children through an equitable, inclusive, and holistic approach.

SUMMARY:

The Medicaid Specialist provides administrative support for Medicaid school services activities for Washtenaw County and the nine local school districts within. The position manages the processing of the districts’ and WISD student medical and school-based service records and Medicaid School Services Program billing. Additionally, the position oversees data collection and ensures all county student and medical information management practices meet district, state and federal requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Demonstrates a strong commitment to equity, social justice, and inclusion in all practices and position responsibilities.
Demonstrates the ability to examine how his/her/their position (directly or indirectly) impacts educational inequities in student achievement outcomes.
Engages in reflection and ongoing learning and development on critical concepts and terms identified in the Washtenaw ISD Educational Equity Policy including concepts such as cultural proficiency, racial equity, and systemic and structural inequities
Manages the processing of student school-based services, records, and submission of medical billing for reimbursement from the state.
Oversees Medicaid eligibility verification, billing of claims and follow-up.
Maintains and provides oversight over WISD/LEA school-based service records, including all approved, voided and adjusted claims.
Monitors monthly claims comparison in CHAMPS to ensure percentage is greater than 85; troubleshoots to resolve if it falls below and informs stakeholders.
Interprets and administers state and federal rules and informs staff, administrators, and local districts of changes.
Ensures that all student and medical information management practices meet district, state, and federal requirements.
Works with finance/business office staff regarding filing quarterly financials, annual Facility Settlements and provides paid service claims and transportation claims reports.
Trains local District staff to maintain compliant cost-based service records to achieve maximum revenue.
Works with specialized software, manages Service Type codes and overall maintenance of records and tracks data related to eligible special education students.
Works with special education registry, technology, finance, and special education staff members to ensure comprehensive flow of data and programming changes.
Works with programmers to develop program enhancements.
Maintains the Medicaid database, including eligibility of students, age requirements, informed parental consent to submit school-based service information, referrals, authorizations, prescriptions, evaluations, and other documentation to support claims.
Maintains database of staff credentials and qualifications to provide eligible school-based services for WISD programs and the LEAs.
Oversees the work of other support staff.
Performs data entry related to areas of responsibility (i.e. scanning/e-filing all scripts, authorizations, referrals, consents, supervision logs, personal care logs).
Runs monthly reports for missing/expired scripts, referrals, authorizations; runs monthly Medicaid eligibility checks; runs weekly submission of claims; facilitate the tracking of personal care services for all WISD programs; runs a daily report for missing parent consents pre-IEP meetings and notify appropriate staff; creates CSRs as necessary to complete tasks involving DCT uploads.
Provides training, technical support and policy interpretation to administration and staff of local districts related to student-based service reimbursement and specialized software; provides training, technical support and/or policy interpretation to administration and staff of other ISDs, as directed.
Monitors data quality and maintains a quality assurance plan for federal/state audits.
Holds quality assurance meetings and performs peer record reviews; updates the Quality Assurance Plan annually.
Provides on-site and/or Zoom trainings to assist LEA and WISD staff regarding Medicaid billing procedures and requirements for compliance.
Develops informational/training presentations and training videos, as requested, for WISD programs and LEAS.
Works with WISD's technology dept in creating/updating reports generated in the special education software management system. Reports are required to provide interpretation and feedback to LEA/WISD superintendents, special education and finance staff related to components of Medicaid reimbursable claims (logging services/monthly progress summaries, prescriptions, parent consents, IEP/IFSP requirements, C4S requirements, transportation in the billing software system, etc).
Creates content and maintains Medicaid School Services Program web page.
Provides technical assistance to LEA administrative staff and special education directors in certifying quarterly calendars and county-wide staff cost pools for direct service, targeted case managers, personal care and Administrative Outreach Program, involving guidance/support on staff credentials, shifts, vacancies and research on Federally Funded staff.
Performs daily “Compliance Report” checks on random moment time studies; contacts local district and/or WISD staff within 24 hours if out of compliance.
Distributes profession specific, county-wide training tip sheets for random moment time study scenarios and provides detailed written information and instructions for completing mandatory follow-up questions sent by state-wide contractor.
Creates monthly Newsletter for 1000+ LEA/WISD staff (including special education directors, asst. directors, asst. superintendents, supervisors) to facilitate the communication of updates/changes to policy, share examples of quality service records and summaries, list end of year tasks, due dates, and provide available time-saving reports to help improve program compliance and maximize cost recovery for the LEAs.
Acts as a liaison during state and federal audits between auditors, WISD Business Office and local district administrators in the Business and Special Education departments.
Represents the District with the State of Michigan for policy interpretation and compliance.
Consults with state and constituent groups about policy change and development.
Stays current on all student and school-based health records practices, laws and regulations.
Oversees the electronic archiving of student, medical and billing documents.
Analyzes data using spreadsheets, databases and other tools.
Performs annual compliance audits in accordance with standards.
Researches and prepares reports for projects as assigned.
Adheres to District rules, policies and procedures.
Supports the WISD vision and mission
Supports a team-based approach to problem solving.
Performs such other tasks as may from time to time be assigned by the supervisor.
Maintains regular predictable attendance.
Other duties as assigned.

SUPERVISORY RESPONSIBILITIES:

N/A.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Alternative requirements that may be appropriate and acceptable to the Board of Education may be considered. 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.

EDUCATION and/or EXPERIENCE:

Possesses an Associates degree or higher in the field of education, health or business – (preferred).
Possesses previous Medicaid billing experience – (preferred).
Possesses business school training or any equivalent combination of experience – (preferred).
Possesses previous experience in or knowledge of school-based records for special education – (preferred).
Possesses previous experience in the support of end users – (preferred).
Possesses previous experience dealing with confidential personal data.
Possesses extensive experience utilizing Microsoft Excel – (preferred).
Possesses such alternatives to the above qualifications as the Board may find appropriate and acceptable.

LANGUAGE SKILLS:

Demonstrates ability to read and interpret documents such as grants, journal articles, governmental forms and handbooks.
Demonstrates ability to express self clearly, both orally and in writing.
Demonstrates ability to speak effectively before from groups of educators, parents, students, and the general public.

TECHNICAL SKILLS:

Demonstrates strong technological skills.
Demonstrates excellent Microsoft Office suite (Microsoft Word, Excel, and PowerPoint, e.g.) skills and knowledge of Apple software and devices.
Demonstrates ability to use a personal computer (PC) in a networked environment to utilize the Internet and other electronic communication mechanisms such as email conferencing.
Demonstrates knowledge of productivity applications such as Microsoft Office (word processing, spreadsheets, database) is – (required).
Demonstrates ability to use Microsoft Office, Zoom, Teams.
Demonstrates knowledge of New World - (preferred).

MATHEMATICAL SKILLS:

Demonstrates ability to perform basic math skills.

REASONING ABILITY:

Demonstrates ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Demonstrates ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Exhibits a high level of professionalism with the ability to handle confidential information, use good judgment, plan, and handle complex projects and maintain a flexible attitude.
Demonstrates knowledge and proficiency in organizational problem-solving.
Demonstrates ability to work under pressure.
Demonstrates ability to see the task through to a successful conclusion.
Demonstrates ability to deal with problems involving several concrete variables in standardized situations.
Exhibits interest and skills in performing multiple tasks.
Demonstrates excellence under deadline pressure.

INTERPERSONAL SKILLS:

Possess excellent customer service and communication skills with a client-centered focus.
Ability to build rapport with others and to serve diverse publics.
Demonstrated ability to work with internal staff, local school districts and the general public.
Demonstrates ability to take the initiative, think creatively and work well with others as a collaborative team member and exhibit good communication skills.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle or feel objects, tools, or controls; reach with hands and arms; talk or hear; and taste or smell. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds such as paper and training material. Specific vision abilities required by this job include close vision, distant vision and the ability to adjust focus. The position requires the individual to sometimes work irregular or extended work hours and meet multiple demands from several people.

ENVIRONMENTAL ADAPTABILITY:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is quiet to loud depending upon the activity in the particular part of the day. The employee is frequently required to interact with the public and other staff. Occasionally the employee may be required to be outdoors for a short period of time, and therefore subject to varying weather conditions, for purposes of accomplishing the essential functions of this job.

FUNCTIONS OF POSITION DESCRIPTION:

This position description has been prepared to define the general duties of the position, provide examples of work and to detail the required knowledge, skills and ability as well as the acceptable experience and training for the position. The description is not intended to limit or modify the right of any supervisor to assign, direct and control the duties of employees under supervision. The WISD retains and reserves any and all rights to change, modify, amend, add to or delete from any portion of this description in its sole judgment.

This position description is not a contract for employment.

The WISD is an equal opportunity employer, in compliance with the Americans with Disabilities Act. The District will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.

TERMS:

Contract, salary and other employment conditions to be established by the Board of Education as reflected in the current Non-Affiliated and Early Childhood Manual. . Starting salary ranging (dependent upon experience) from $68,317 – $83,963.

Washtenaw Intermediate School District is a drug-free workplace.

It is the policy and commitment of the Washtenaw Intermediate School District not to discriminate on the basis of race, color, religion, national origin, sex, disability, age, height, weight, familial status, marital status, genetic information, sexual orientation or any legally protected characteristic, in its educational programs, activities, admissions, or employment policies in accordance with Title IX of the 1972 Educational Amendments, executive order 11246 as amended, Section 504 of the Rehabilitation Act of 1973 and all other pertinent state and federal regulations.