Specialist, Third Party Billing

BALTIMORE COUNTY PUBLIC SCHOOLS

CLASS TITLE : Specialist, Third Party Billing

REPORTS TO : Supervisor, Third Party Billing

DEFINITION : Provides leadership, expertise, training, and assistance to service providers and others with respect to Medicaid reimbursements and other Office of Third Party Billing matters. Analyzes and develops program policies and procedures. Monitors and audits program compliance. Serves as project manager for automated system projects. Serves as a liaison to the Department of Information Technology and system vendors. Serves as a liaison between the Office of Third Party Billing and schools and offices. Supervises administrative support staff. Performs other duties as assigned.

EXAMPLES OF DUTIES :

• Coordinates third party billing for case management and health-related services provided by special education teachers and related services providers.
• Provides advice, guidance, and consultation to service providers regarding third party billing and related matters. Receives and responds to questions and inquiries from service providers.
• Develops, revises, and produces training materials such as written guides, booklets, and manuals. Schedules and conducts in-service training workshops and sessions. Prepares and provide online and face to face presentations to school-based service providers and others.
• Reviews results from Third Party Billing school monitoring, Internal Audit monitoring, Interagency Medicaid Monitoring Team monitoring, and Federal and State audits. Analyzes monitoring results to determine when technical assistance is needed for school-based service providers.
• Reviews and monitors case management and health related services data and other materials submitted by service providers. Ensures that forms and materials are in compliance with applicable laws, procedures, and standards.
• Assists in planning and executing the goals and objectives of the Office of Third Party Billing. Ensures program compliance with the Health Insurance Privacy and Portability Act (HIPPA) of 1996.
• Collaborates with staff to determine the compliance levels of schools with regard to the submission of case management services. Conducts internal audits. Determines the number of case management and related service records received from service providers.
• Prepares reports which measure reimbursement and other program indicators. Keeps current with Medicaid laws and regulations.
• Analyzes and monitors Office of Third Party Billing processes strategies, systems and operations. Assists and coordinates various automation and operational improvement initiatives.
• Serves as the project manager for specified automated system projects. Tracks and reports project status. Serves as a liaison to the Department of Technology and billing vendor. Perform file maintenance functions for the School Based Health Center program.
• Collaborates and troubleshoots technical issues to improve efficiency of billing systems and office operations.
• Utilizes automated systems to research, gather, and report data. Collaborates with staff to identify information processing, reporting, and program requirements.
• Makes appropriate recommendations to the medical assistance billing vendor to effectively maintain and/or modify automated system.
• Administers and manages the Third Party Billing SharePoint website. Creates and maintains SharePoint lists and document libraries. Manages and controls SharePoint Security. Designs, creates, and enhances SharePoint workflows, web parts and surveys where necessary to automate, support, and maintain the Third Party Billing Share Point web application. Perform mass imports of large data files into various document libraries.
• Plans and provides technical guidance in the implementation, maintenance, and enhancements of Third Party Billing, Infants and Toddlers, and School Based Health Center, automated billing systems and associated software and equipment. Trains users on system enhancements and changes.
• Leads and oversees the testing of system integration and system updates to ensure the accuracy of data that drives the billing of Medicaid services provided to special education students.
• Collaborates with Supervisor to respond to auditor requests. Access automated information system and document management solutions to best meet users' requirements. Collaborates with Department of Technology staff to identify and implement report archiving systems and process and tools to provide on-line access to reports.
• Maintains report libraries. Develops and maintain reporting hierarchies in the billing systems. Collaborates with the Department of Technology to maintain the Office of Third Party Billing Web page.
• Confers with users. Provides advice and guidance to departmental management regarding automation and operational issues. Represents the office in meetings and on committees.

MINIMUM QUALIFICATIONS :

Education, Training and Experience :

• Graduation from an accredited college or university with a bachelor's degree.
• Three years' professional experience as an administrator or systems analyst.
• Experience with Medicaid billing administration, staff development and training, or special education preferred.

Knowledge, Skills, and Abilities :

• Knowledge of Medicaid laws, rules, and regulations.
• Knowledge of the principles and practices of third party billing.
• Knowledge of the principles and practices of staff development.
• Knowledge of automated business systems and advanced reporting tools.
• Demonstrated proficiency in principles and practices of computer/system administration.
• Advanced knowledge of third-generation programming languages, databases, reporting tools and data archiving methodologies.
• Knowledge of personal computers and office software applications.
• Skill in the development of training materials and presentations.
• Skill in providing in-service training.
• Skill in providing advice, guidance, and assistance to employees.
• Skill in analyzing procedures and practices and developing improvements.
• Skill in preparing reports and presenting data.
• Skill in trouble shooting system malfunctions.
• Ability to develop an expertise in the operation of automated applications, websites and verifies data integration between the medical billing systems and feeder systems, including various data systems, Maryland Department of Health billing system.

PHYSICAL AND ENVIRONMENTAL CONDITIONS :
The work of this class is generally performed in an office environment and requires travel to school and office sites throughout the county.

FLSA : Exempt

SALARY: Grade 07 on the BCPS OPE 12 Month payscale $74,484 - $115,151.

Eligible for the Baltimore County Employees' Retirement System.

This document describes the duties and responsibilities of a position. It shall not be held to exclude duties not referenced nor limit the right of management to assign work to employees.

Citizenship, residency or work VISA in United States required

Application Instructions
Please read and carefully follow the instructions provided below.

• Applicants are required to have a completed application on file for employment with Baltimore County Public Schools (BCPS). Each time an applicant applies to a job with BCPS, the application must be resubmitted. If an applicant started an application with BCPS in the past and at a later date decides to apply for additional positions, it is the applicant's responsibility to review the entire application and ensure that all data is up to date (for example, the applicant may need to add additional schooling or certifications, an additional work experience, or provide updated references). The applicant must remember to review the entire application each time for accuracy and submit each time for a new or different vacancy.
• Professional references must be submitted to complete your application. Examples of professional references include current and former principals, supervisors, managers, mentor teachers and university/college supervisors. Personal references from colleagues, friends, community members, etc. will not be accepted. Applicants should notify their reference proactively to inform them they will receive a form via email through a MAILBOT email address from Baltimore County Public Schools. Applicants should also inform their reference(s) of the job they are applying to.
• Be sure to account for all periods of employment and unemployment, including student teaching and internship experience, and include names, addresses, and telephone numbers of employers.
• Be sure to answer all criminal background questions. If you answer "yes" to any of the criminal background questions you must provide a written explanation. A criminal offense does not necessarily exclude an applicant from employment with BCPS. Factors such as passage of time since the offense, the nature of the violation, and the extent of rehabilitation will be taken into consideration.

Pre-Employment Requirements:

• All persons employed by the Baltimore County Public Schools, regular and temporary, are required to be fingerprinted and have a criminal background investigation (State of Maryland, Senate Bill 315, effective October 1, 1986) completed. The fee charged for fingerprinting is $81.00 . An identification card will be issued which must be shown prior to employment.
• Anyone offered employment is required to provide proper identification and documentation of eligibility for employment in the US.
• If you have military experience you will be asked to provide a copy of DD214.
• Official transcripts for all higher education must be received prior to contract signing.
• Some positions will require employees to undergo a physical examination and/or drug testing.
• All newly hired personnel must attend a Badges and Benefits session.
• Additional job verification will be required for salary credit.

Non-Discrimination Statement

The Board of Education of Baltimore County does not discriminate on the basis of race, color, religion, sex, national origin, age, marital status, sexual orientation, gender identity, genetic information, disability, or veteran status in matters affecting employment or in providing access to educational programs or activities and provides equal access to the Boy Scouts and other designated youth groups. Inquiries regarding the Board's nondiscrimination policies should be directed to: EEO Officer, Office of Equal Employment Opportunity, Baltimore County Public Schools, 6901 Charles Street, Building B, Towson, Maryland 21204 (443-809-8937). There is a compliance officer responsible for identifying, preventing, and remedying prohibited harassment concerning students. Complaints of harassment should be directed to the executive director, Department of School Safety and Security, 9610 Pulaski Park Drive, Suite 219, Baltimore, Maryland 21220 (443-809-4360).

Contact Information

Michael Hodge
HR Supervisor
Business Services Staffing
6901 Charles Street, E Building
Towson, Maryland 21204
Phone: 443-809-7872 or 7873
Fax: 410-296-0568
Email: mhodge@bcps.org