Original listing text, shown exactly as published by the company.
The following are key responsibilities related to the position
MediCal Compliance Leadership
- Ensure that all MediCal billing and documentation processes are compliant with federal and state regulations.
- Monitor changes in MediCal regulations and guidelines, ensuring all school staff are trained on updates and procedures.
- Oversee the preparation, submission, and follow-up of MediCal claims, ensuring accuracy and timely processing.
Reimbursement Management
- Manage the reimbursement process for services provided to eligible students, ensuring that all claims are filed correctly and promptly.
- Conduct regular audits of reimbursements to ensure compliance with both internal policies and external regulations.
- Serve as the primary point of contact for any reimbursement-related inquiries, including communication with insurance providers, MediCal representatives, and school staff.
- Reconcile reimbursement accounts, ensuring all payments are processed, tracked, and documented appropriately.
Process Improvement Efficiency
- Identify areas for process improvement within the MediCal billing and reimbursement workflow.
- Develop and implement strategies for streamlining the reimbursement process, reducing errors, and improving turnaround times.
- Lead initiatives to enhance the overall efficiency of compliance and reimbursement procedures across the regional network.
Training & Support
- Provide training and ongoing support to school staff and regional team members on MediCal compliance and reimbursement best practices.
- Ensure staff is equipped with up-to-date resources and knowledge on MediCal eligibility, services covered, and billing procedures.
Collaboration & Reporting
- Work closely with the finance and operations teams to ensure that MediCal-related revenue is properly reflected in school budgets.
- Prepare detailed reports on reimbursement activities, compliance status, and potential areas of concern for senior leadership.
- Assist with any audits or reviews related to MediCal compliance and reimbursement, providing requested documentation and explanations.
Qualifications
- Education: Bachelor’s degree in Finance, Business Administration, Healthcare Administration, or a related field.
- Experience:
- Minimum of 3 years of experience in MediCal billing, reimbursement, or compliance, preferably in an educational or healthcare setting.
- Strong understanding of federal and state MediCal regulations and compliance requirements.
- Previous experience working in public schools or charter schools is a plus.
- Skills & Competencies:
- High attention to detail with the ability to manage large volumes of data accurately.
- Exceptional communication skills, both written and verbal.
- Strong organizational skills with the ability to prioritize tasks effectively.
- Ability to work independently and collaboratively in a fast-paced environment.
- Proficiency with reimbursement software and systems (e.g., MediCal billing software, spreadsheets, etc.).
- Problem-solving mindset and ability to navigate complex regulations.
Working Conditions
- This is an hourly, full-time position with a flexible schedule, typically requiring 40 hours per week.
- Some evening or weekend work may be required to meet deadlines or address urgent issues.
- The role involves working both remotely and in-office, with occasional travel to school sites for training or compliance reviews.
