COORDINATOR MEDICAID OPERATIONS

Essential Functions. An individual in this role must be able to perform the following functions with or without reasonable accommodation:

• Coordinates the implementation of MSBS policy and/or program changes.
• Ensures compliance of all federal, state, and MSBS program requirements.
• Utilizes and manages internal and external data related to Medicaid billing for applicable IEP services and for the expansion of Free Care services to include IHP/504/BIP/Other, including the preparation and analysis of regular monthly reports.
• Updates policies/procedures in obtaining required billing information from related service providers serving Medicaid-eligible students.
• Obtains, maintains, and reviews records, reports and all necessary documents.
• Communicates with the New Mexico Human Services Department, New Mexico Medical Assistance Division, and New Mexico State Department of Education.
• Oversees authorizations of IEP related services by appropriate medical personnel.
• Serves as liaison between APS MSBS and any appropriate outside agencies on operational issues.
• Consults, assists, and trains related service providers in MSBS program requirements including maintaining necessary records for filing and audit purposes.
• Consults and networks with other school districts in New Mexico.
• Conducts presentations on MSBS program in APS as required.
• Participates on local and state Medicaid committees.
• Conducts system audits to ensure compliance.
• Develops and maintains public relations contacts with local Managed Care Organizations (MCOs).
• Coordinates with Special Education on department program components that affect Medicaid.
• Monitors the implementation and timely filing of the administrative time-study.
• Provides training for new Medicaid Compliance Specialists and monitors workflow of Medicaid Establishes internal procedures for timely implementation of MSBS requirements.
• Assists Supervisor in forecasting and analysis of MSBS program.
• Serves as MSBS liaison with Supervisor and Department Director.

Duties. All duties are standard and apply to all Albuquerque Public Schools employees.

• Complies with state-approved Code of Ethics of the Education Profession, APS employee handbook, employment contract and upholds and enforces rules, administrative directives and regulations, school board policies, and local, state and federal regulations.
• Articulates and facilitates the implementation of the mission and values of the Albuquerque Public Schools.
• Safeguards confidentiality of privileged information.
• Prepares and maintains accurate and complete records and reports as required by law, state directives, District policy and administrative regulations.
• Shares the responsibility for the supervision and care of District inventory, proper and safe use of facilities, equipment and supplies, and reports safety hazards promptly.
• Maintains professional relationships and works cooperatively with employees, the community and other professionals.
• Maintains professional competence through District mandated, individual and staff training, in-service educational activities and self-selected professional growth activities.
• Attends and/or conducts staff meetings and participates on committees within areas of responsibility.
• Performs other tasks related to area of responsibilities as requested or assigned by an immediate supervisor.

Preferred Knowledge, Skills & Abilities.

• Effective communication skills, both verbal and written.
• Flexibility, organization, decision-making and problem solving skills.
• Interpersonal skills with diverse populations in-person and on the telephone.
• Ability to meet deadlines and work on multiple projects.
• Ability to coordinate the work of others.
• Proficient with word processing, database and spreadsheet software.
• Accounting/bookkeeping skills.
• Knowledge of Medicaid Federal and State regulations, procedures and laws.
• Knowledge of State Medical Assistance Division and Medicaid reimbursement in schools.
• Knowledge of fiscal agent procedures.
• Knowledge of special education functioning in schools.
• Ability to present ideas and plans, apply research techniques and remediate problems to forecast needs.
• Ability to assess, plan, intervene and re-evaluate the program.

Required Education, Licenses, Certifications, & Experience.

• Bachelors degree in Business Administration, Computer Systems or related field.
• Six years of Medicaid related experience.