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Medicaid Specialist

Spartanburg District 5 Schools
Roebuck, SC Full Time
POSTED ON 3/5/2025
AVAILABLE BEFORE 6/4/2025

Announcement of Vacancy for :

Medicaid Specialist

Minimum Qualifications :

  • High School Diploma (Required) with a College Degree Preferred
  • At least 5 years of experience in a medical billing office setting (school district experience is preferred, but not required)
  • 5 years' experience with Medicaid insurance, billing, school based programs

Performance Responsibilities :

  • Ensures the submittal of all contracts
  • Assist in identifying, developing, and implementing strategies to maximize Medicaid reimbursement for services provided to eligible students.
  • Prepares and submits school district claims to third-party insurance carriers and the State of South Carolina electronically.
  • Secures needed medical documentation required or requested by insurances.
  • Follows up with insurance carriers on unpaid claims till claims are paid
  • Processes rejections by correcting any billing error and resubmitting claims to insurance carriers.
  • Works with school district providers to ensure that correct diagnosis / procedures are reported to insurance carriers.
  • Keeps updated on all billing and benefit changes for third-party insurance carriers.
  • Monitors claims for missing information and authorization / control numbers and works with the Medicaid eligibility staff
  • Maintains confidentiality of all information.
  • Completes work within authorized time to assure compliance with departmental standards.
  • Monitor Medicaid funding, track data, and ensure compliance with applicable rules and regulations.
  • Keeps updated on all third-party billing requirements and changes for insurance types within the area of responsibility.
  • Coordinates with the Finance / Procurement Officer billing reviews to be shared with other departments
  • Works with other departments on plans to sustain health services programs through insurance billings
  • Performs other duties as required.
  • Contract Length : 240 day

    Salary : Spartanburg School District Six Salary Schedule

    Filing Deadline : Until Filled

    Effective Date of

    Employment : TBD

    Please apply on-line through the District 6 website

    All applicants must provide 3 references. If possible, one of the three should be a personal reference. Please make sure your references complete the survey that is emailed to them.

    Spartanburg School District Six does not discriminate on the basis on race, sex, color, religion, national origin, age, disability, or veteran status in the provision of education opportunities and benefits in compliance with Title VI and VII of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the employment provisions (Title I) of the Americans With Disabilities Act of 1990, Age Discrimination and Employment Act, and all other applicable civil rights laws.

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