DISTINGUISHING FEATURES OF THE CLASS:  This position exists in the Schenectady City School District and involves responsibility for the review and assembly of documentation to support Medicaid claims to the New York State School Supportive Health Services Program.  Duties performed are primarily focused on the specialized programmatic tasks relating to using computer-based applications/software to support Medicaid reimbursement for clinical services provided to district students with disabilities.  The work is varied with many complex moving parts to ensure compliance and is performed under the general direction of the Assistant Superintendent of Student Support Services with leeway given for the exercise of independent judgment in dealing with established Medicaid guidelines.  Does related work as required.

TYPICAL WORK ACTIVITIES: 

• Reviews and processes claims and related documentation for completeness and accuracy in accordance with NYS and federal guidelines and regulations;
• Monitors accuracy of digital documentation;
• Monitors compliance of prescriptions, documented sessions, evaluations, USO (Under the Supervision of)/UDO (Under the Direction of) documentation and IEP accuracy;
• Resolves documentation discrepancies;
• Trains staff in processes and procedures and sets up users in the billing software;
• Analyzes and monitors claim submissions;
• Compiles statistics on timely submissions;
• Routinely monitors providers’ license verifications;
• Runs queries to monitor the status of scripts, evaluations and USO/UDO compliance;
• Routinely monitors the activity and history of each provider using the billing software;
• Updates the providers and users in the billing software as needed;
• Provides reports on the status and findings of Medicaid audits;
• Communicates audit observations, recommandations and process improvements;
• Coordinates auditing outcomes with Medicaid Compliance Officer to identify, develop and publish corrective actions/educational material related to audit errors;
• Prepares original correspondence to employees and other clientele on a variety of Medicaid related issues;
• Provides annual Welcome Back to all users/staff with Q&A instructions on Medicaid requirements;
• Maintain monthly USO/UDO monthly/quarterly logs and ensure compliance with timely submission;
• Prepares reports that maintain the vitality of the Medicaid revenue;
• Maintains electronics and hard copy files and records as required;
• Coordinates the development of processes and procedures;
• Assists to ensure compliance with all applicable federal and state laws;
• Performs a variety of data entry of information into various systems used by the district/department;
• Performs other duties as assigned consistent with the goals and responsibilities of this position and as directed by the Assistant Superintendent of Student Support Services or his/her designee.

FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS:  Comprehensive knowledge of the rules and regulations of the New York State School Supportive Health Services Program; thorough knowledge of Microsoft Office Suite; good knowledge of English; Good knowledge of the principles and practices involved in the organization of record keeping; ability to understand and carry out complex oral and written instructions; Ability to understand, use and explain complex regulations to others both orally and in writing in a clear and concise manner; ability to detect and define reporting irregularities and give recommendations on effective corrective measures; ability to prepare factual, clear and comprehensive analyses and to make sound recommendations; ability to create and use complex spreadsheets and databases; ability to acquire a knowledge of technical medical terminology and

usage; ability to establish good working relationships with clinicians and other staff members at all levels as well as those from outside agencies/schools; ability to manage a heavy workload and work with a high degree of independence to meet goals and deadlines; ability to deal with controversial matters in a tactful manner; ability to maintain confidential information; excellent analytical, problem-solving and decision making skills. 

SALARY:  Per CSEA Contract

LOCATION: Central Office

DISTINGUISHING FEATURES OF THE CLASS:  This position involves responsibility for operating information processing equipment in accordance with programmed instructions by manipulation of a standard alpha-numeric keyboard and related peripheral equipment to record, edit, store and revise correspondence, reports, statistical, accounting and a variety of other forms of data.  Information processing equipment includes: A remote computer terminal linked to a mainframe computer, a stand alone internal processing unit such as a micro-computer, or similar computer equipment.  This position does not involve responsibilities in the areas of programming or systems analysis.  However, an incumbent may modify or merge existing software packages or other program language in accomplishing word processing and other micro-computer functions.  Additionally, when not engaged in equipment operation, an incumbent performs a variety of clerical duties.  Direct supervision is received from a higher level clerical or administrative staff with detailed instructions given for new or difficult assignments.  The incumbent does related work as required.

TYPICAL WORK ACTIVITIES:

• Operates information processing equipment and related peripheral equipment such as daisy wheel printer or dot matrix printer in compiling and processing data for a variety of records and related reports;
• Maintains records on information processing equipment by manipulating the keyboard to enter new data or edit existing data;
• Manipulates the keyboard in order to make file searches;
• Maintains disk directories and other storage media used in information processing operations;
• Updates table of contents or index entries as appropriate to identify files, records and documents;
• Retrieves necessary data from information processing equipment in order to print out required reports;
• Operates information processing equipment in word processing mode to record, edit, store and revise correspondence, reports, statistical tables, forms and other textural materials and documents;
• Sets up appropriate controls on equipment for margination, line spacing, paragraph, heading and footer information and other controls as necessary for document amendment or production;
• Prints completed documents to draft or letter quality as appropriate and forwards to supervisor or administrator for review;
• Analyzes machine stops and observes indicators on console and peripheral equipment and takes necessary steps to verify proper functioning of the equipment;
• Performs routine minor operator preventative maintenance on information processing equipment as specified by manufacturer to insure efficient and effective operation;
• Confers with superiors on projects as to procedures, machine time, rate of output and difficulties encountered;
• Assists in training new personnel on information processing equipment as requested;
• Makes arithmetical computations and compiles simple statistical reports;
• Performs a variety of clerical functions related to the position;
• Performs a variety of related tasks as required.

FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS:  Good knowledge of the use and operation of information processing equipment and related peripheral equipment; working knowledge of office terminology and procedures, working knowledge of proper grammatical usage and punctuation; working knowledge of business vocabulary; ability to manually manipulate information processing equipment; ability to determine and set up appropriate document formats, charts and tabular listings for word processing mode; ability to coordinate information from typed or handwritten copy to word processing mode and verify document of a cathode ray tube visual screen; ability to understand and follow oral and written instructions; accuracy.

NOTE:  The essential functions of this job are determined by the department/jurisdiction where the job is located.

DISTINGUISHING FEATURES OF THE CLASS:  This position involves responsibility for operating information processing equipment in accordance with programmed instructions by manipulation of a standard alpha-numeric keyboard and related peripheral equipment to record, edit, store and revise correspondence, reports, statistical, accounting and a variety of other forms of data.  Information processing equipment includes: A remote computer terminal linked to a mainframe computer, a stand alone internal processing unit such as a micro-computer, or similar computer equipment.  This position does not involve responsibilities in the areas of programming or systems analysis.  However, an incumbent may modify or merge existing software packages or other program language in accomplishing word processing and other micro-computer functions.  Additionally, when not engaged in equipment operation, an incumbent performs a variety of clerical duties.  Direct supervision is received from a higher level clerical or administrative staff with detailed instructions given for new or difficult assignments.  The incumbent does related work as required.

TYPICAL WORK ACTIVITIES:

• Operates information processing equipment and related peripheral equipment such as daisy wheel printer or dot matrix printer in compiling and processing data for a variety of records and related reports;
• Maintains records on information processing equipment by manipulating the keyboard to enter new data or edit existing data;
• Manipulates the keyboard in order to make file searches;
• Maintains disk directories and other storage media used in information processing operations;
• Updates table of contents or index entries as appropriate to identify files, records and documents;
• Retrieves necessary data from information processing equipment in order to print out required reports;
• Operates information processing equipment in word processing mode to record, edit, store and revise correspondence, reports, statistical tables, forms and other textural materials and documents;
• Sets up appropriate controls on equipment for margination, line spacing, paragraph, heading and footer information and other controls as necessary for document amendment or production;
• Prints completed documents to draft or letter quality as appropriate and forwards to supervisor or administrator for review;
• Analyzes machine stops and observes indicators on console and peripheral equipment and takes necessary steps to verify proper functioning of the equipment;
• Performs routine minor operator preventative maintenance on information processing equipment as specified by manufacturer to insure efficient and effective operation;
• Confers with superiors on projects as to procedures, machine time, rate of output and difficulties encountered;
• Assists in training new personnel on information processing equipment as requested;
• Makes arithmetical computations and compiles simple statistical reports;
• Performs a variety of clerical functions related to the position;
• Performs a variety of related tasks as required.

FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS:  Good knowledge of the use and operation of information processing equipment and related peripheral equipment; working knowledge of office terminology and procedures, working knowledge of proper grammatical usage and punctuation; working knowledge of business vocabulary; ability to manually manipulate information processing equipment; ability to determine and set up appropriate document formats, charts and tabular listings for word processing mode; ability to coordinate information from typed or handwritten copy to word processing mode and verify document of a cathode ray tube visual screen; ability to understand and follow oral and written instructions; accuracy.

NOTE:  The essential functions of this job are determined by the department/jurisdiction where the job is located.