Job description
JOB DESCRIPTION
Job Title
Specialist, SHARS
Evaluation Type
Paraprofessional
Department
Special Programs & Services
Pay Grade
P6
FLSA
Non-Exempt
Date Revised
March 2019
Supervisor
Director of Special Programs & Services
BASIC FUNCTION & RESPONSIBILITY:
Responsible for coordinating the SHARS-Medicaid Eligibility Determination and Claims Tracking Operations. Responsible for processing and tracking incoming Medicaid claims to ensure claims are received for the delivery of speech therapy, nursing services and comprehensive individual assessments (CIA). Responsible for verifying student Medicaid eligibility on the TDH’s Client Eligibility Inquiry system. Travels to campuses to provide on-site support and training.
CHARACTERISTIC DUTIES & RESPONSIBILITIES:
The essential functions, pursuant to the Americans with Disabilities Act, may include the characteristic duties, responsibilities, knowledge, skills, and abilities noted herein; however, this is not a comprehensive listing of all functions and tasks performed by positions found in this job description.
Support of Administrative, Fiscal, and/or Facilities Function:
1. Track Medicaid claims for Assessments, Counseling, Medical Services, Occupational Therapy and/or Evaluations, Personal Care Services, Physical Therapy and/or Evaluations, Psychological, Nursing Services, Special Transportation, Speech Therapy and/or Evaluations and Behavioral Services and any other Medicaid Billable service.
2. Collaborate with representatives from contracted agencies (Medicaid Billing and Electronic IEP System) and BISD Finance Department to ensure accurate reporting of SHARS/Medicaid reimbursement.
3. Maintain working knowledge of the following websites and/or programs all programs required for job completion, including: School Health and Related Services (SHARS), Texas Medicaid & Healthcare Partnership (TMHP), Fairbanks, Special Education IEP Systems, Texas Education Agency (TEA) and Student Information Systems.
4. Manage and perform utilization review of all in-coming claims for the SHARS program to ensure the district’s reimbursement for Medicaid Billable Services are achieving established fiscal revenue projections.
5. Coordinate, conducts, and maintain records for district-wide Medicaid and RMTS training sessions for service providers regarding the SHARS program in order to facilitate proper compliance for ARDs and SHARS Medicaid Regulatory procedures for claiming and maximizing reimbursement efforts.
6. Oversee and compose accurate SHARS Transportation service tickets each month for submission to Medicaid Billing Agency.
7. Develop and coordinate procedures for Medicaid data collection, billing, reimbursement, medical records tracking/retention, service reporting, and utilization review of the SHARS being delivered by district health providers.
8. Provide and maintain lists of eligible Medicaid students for appropriate service providers that includes currently served students, students who transfer to BISD with Medicaid Billable Services in their IEP, and students newly eligible for Medicaid Billable Services.
9. Maintain current personnel lists for BISD in order to submit quarterly participant lists for Medicaid Billing purposes.
10. Ensure a uniform monthly deadline is in place with billing clinicians for maximum billing efforts. Maintain this effort by producing billing reports for providers/students. When necessary correspond with clinicians via electronic mail, phone calls, and/or campus visits.
11. Maintain a system for tracking and retaining signed and/or unsigned Medicaid Billing Consents for auditing purposes.
12. Download and maintain Remittance Reports, Status Reports, and Certificate of Funds for BISD.
13. Collaborate with ARD Facilitators and Services Providers in the auditing of ARD documents to ensure accurate documentation of Medicaid Billable Services as well as participation in the RMTS Program.
14. Maintain a filing system and storage of files in accordance with records retention rules and regulations for audit purposes.
15. Maintain a system of Medical Referrals submitted to Physicians and/or received by Physicians for the provision of Occupational and Physical Therapies.
1. Track Medicaid claims for Assessments, Counseling, Medical Services, Occupational Therapy and/or Evaluations, Personal Care Services, Physical Therapy and/or Evaluations, Psychological, Nursing Services, Special Transportation, Speech Therapy and/or Evaluations and Behavioral Services and any other Medicaid Billable service.
2. Collaborate with representatives from contracted agencies (Medicaid Billing and Electronic IEP System) and BISD Finance Department to ensure accurate reporting of SHARS/Medicaid reimbursement.
3. Maintain working knowledge of the following websites and/or programs all programs required for job completion, including: School Health and Related Services (SHARS), Texas Medicaid & Healthcare Partnership (TMHP), Fairbanks, Special Education IEP Systems, Texas Education Agency (TEA) and Student Information Systems.
4. Manage and perform utilization review of all in-coming claims for the SHARS program to ensure the district’s reimbursement for Medicaid Billable Services are achieving established fiscal revenue projections.
5. Coordinate, conducts, and maintain records for district-wide Medicaid and RMTS training sessions for service providers regarding the SHARS program in order to facilitate proper compliance for ARDs and SHARS Medicaid Regulatory procedures for claiming and maximizing reimbursement efforts.
6. Oversee and compose accurate SHARS Transportation service tickets each month for submission to Medicaid Billing Agency.
7. Develop and coordinate procedures for Medicaid data collection, billing, reimbursement, medical records tracking/retention, service reporting, and utilization review of the SHARS being delivered by district health providers.
8. Provide and maintain lists of eligible Medicaid students for appropriate service providers that includes currently served students, students who transfer to BISD with Medicaid Billable Services in their IEP, and students newly eligible for Medicaid Billable Services.
9. Maintain current personnel lists for BISD in order to submit quarterly participant lists for Medicaid Billing purposes.
10. Ensure a uniform monthly deadline is in place with billing clinicians for maximum billing efforts. Maintain this effort by producing billing reports for providers/students. When necessary correspond with clinicians via electronic mail, phone calls, and/or campus visits.
11. Maintain a system for tracking and retaining signed and/or unsigned Medicaid Billing Consents for auditing purposes.
12. Download and maintain Remittance Reports, Status Reports, and Certificate of Funds for BISD.
13. Collaborate with ARD Facilitators and Services Providers in the auditing of ARD documents to ensure accurate documentation of Medicaid Billable Services as well as participation in the RMTS Program.
14. Maintain a filing system and storage of files in accordance with records retention rules and regulations for audit purposes.
15. Maintain a system of Medical Referrals submitted to Physicians and/or received by Physicians for the provision of Occupational and Physical Therapies.
Organization Improvement:
16. Train all billing personnel annually on eSHARS and RMTS for Bastrop ISD. Keep track of new hires throughout the school year and conduct trainings on a quarterly basis for new staff. Travel within BISD to provide on-site support and training.
17. Work collaboratively to improve programs and suggest ways to improve efficiency and productivity.
16. Train all billing personnel annually on eSHARS and RMTS for Bastrop ISD. Keep track of new hires throughout the school year and conduct trainings on a quarterly basis for new staff. Travel within BISD to provide on-site support and training.
17. Work collaboratively to improve programs and suggest ways to improve efficiency and productivity.
Professional Growth and Development:
18. Attend SHARS, SHARS Cost Report, RMTS and MAC trainings through webinars and/or in person to maintain compliance and keep informed of rules and regulations.
19. Participate in professional development that increases effectiveness and improves District performance.
18. Attend SHARS, SHARS Cost Report, RMTS and MAC trainings through webinars and/or in person to maintain compliance and keep informed of rules and regulations.
19. Participate in professional development that increases effectiveness and improves District performance.
School/Community Relation
s:
20. Interact positively with employees and the community to provide needed information and to promote the District in a favorable manner.
21. Assist parents, students, teachers, and staff with a positive attitude while supporting the mission of the department and the District.
20. Interact positively with employees and the community to provide needed information and to promote the District in a favorable manner.
21. Assist parents, students, teachers, and staff with a positive attitude while supporting the mission of the department and the District.
Organization Morale:
22. Participate in team building activities and the decision-making process as appropriate.
23. Communicate and collaborate with campus/department staff to enhance service delivery and customer satisfaction.
22. Participate in team building activities and the decision-making process as appropriate.
23. Communicate and collaborate with campus/department staff to enhance service delivery and customer satisfaction.
Other Responsibilities:
24. Comply with policies established by federal and state law, including but not limited to State Board of Education and local Board policy.
25. Perform other job-related duties as assigned.
24. Comply with policies established by federal and state law, including but not limited to State Board of Education and local Board policy.
25. Perform other job-related duties as assigned.
SUPERVISION EXERCISED:
None
KNOWLEDGE, SKILLS & ABILITIES:
- Knowledge of Texas Education agency rules, regulations, and procedures.
- Knowledge and/or ability to learn state and federal regulatory policies and procedures related to SHARS and Medicaid
- Knowledge of Special Education Services preferred.
- Knowledge of effective communication and interpersonal practices.
- Sill in typing, organization, and file maintenance.
- Skill in operating standard computer and software applications, including but not limited to electronic mail, word processing, spreadsheets, databases, and presentations.
- Skill in communicating effectively, both verbally and in writing.
- Skill in researching and analyzing data and reports for federal and state programs.
- Ability to prioritize and organize work responsibilities.
- Ability to demonstrate good judgment when decision-making and problem solving.
ENTRY QUALIFICATIONS:
One to three years of secretarial or bookkeeping experience, preferably in a public education setting.
PHYSICAL & MENTAL DEMANDS:
- Maintain emotional control under stress
- Work with frequent interruptions.
- Occasional prolonged hours
- Use computer for prolonged period resulting in repetitive hand motions.
- Sit for extended periods of time.
- Occasional lifting and carrying (less than 30 pounds)
ENVIRONMENTAL FACTORS:
Work is normally performed in a typical interior/office with no unusual physical demands or exposure to hazardous situations.
Primary Location
Special Programs and Services
Salary Range
$16.47 - $25.24 / Per Hour
Shift Type
Full-Time
JOB CONTACT INFORMATION
Name
Dana Teague
Title
Coordinator
Phone
Email
dteague@bisdtx.org
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