Medicaid Billing Specialist

Position Type:
Secretarial/Clerical

Date Posted:
5/4/2026

Location:
Special Services
Medicaid Billing Specialist

Position Title: Medicaid Billing Specialist
Department: Special Services / Business Office
Reports To: Director of Special Services / Director of Business Operations
FLSA Status: Non-Exempt
Location: Show Low Unified School District
Calendar: 260 days / 8 hours per day

Classified Placement Chart - Column D

Position Summary:

The Medicaid Billing Specialist is responsible for coordinating and processing Medicaid reimbursement activities for eligible student services. This position ensures accurate documentation, billing, and compliance with federal, state, and district requirements. The specialist works closely with Special Services staff, service providers, and business office personnel to support timely reimbursement and maintain audit-ready records. This role requires strong attention to detail, knowledge of compliance requirements, and the ability to manage sensitive data in a highly regulated environment.

Minimum Qualifications:

• High School Diploma or GED required; Associate's degree or higher in healthcare administration, business, or related field preferred.
• Experience in Medicaid billing, medical billing, or school-based service billing preferred.
• Knowledge of Medicaid regulations, billing procedures, and documentation requirements preferred.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook) and billing or data management systems.
• Strong organizational and analytical skills.
• Ability to maintain confidentiality and handle sensitive information (FERPA/HIPAA).
• Strong attention to detail and accuracy in data entry and reporting.
• Arizona IVP Fingerprint Clearance Card.

Core Job Functions:

Medicaid Billing and Documentation:

1. Billing Coordination:
   • Process Medicaid billing claims for eligible student services in accordance with state and federal guidelines.
   • Verify service documentation to ensure accuracy, completeness, and compliance prior to submission.
   • Track and monitor submitted claims, including follow-up on denials, corrections, and resubmissions.
2. Documentation Compliance:
   • Review service logs, IEPs, and related documentation to ensure alignment with Medicaid billing requirements.
   • Ensure all provider documentation meets required standards for reimbursement.
   • Maintain organized, audit-ready records for all billed services.
3. Provider Support and Training:
   • Provide guidance to service providers on documentation requirements and billing procedures.
   • Assist in training staff on Medicaid billing processes and compliance expectations.
   • Serve as a resource for questions related to billing eligibility and documentation.
4. Data Management and Reporting:
   • Maintain accurate billing records and databases.
   • Generate reports related to billing activity, reimbursements, and outstanding claims.
   • Reconcile billing data with internal records and financial systems as needed.

Compliance and Audit Support:

1. Regulatory Compliance:
   • Ensure all billing activities comply with Medicaid regulations, district policies, and applicable laws.
   • Stay current on changes to Medicaid billing requirements and implement necessary updates.
2. Audit Preparation:
   • Prepare documentation and records for audits, reviews, and monitoring activities.
   • Assist with internal audits to ensure ongoing compliance and identify discrepancies.
   • Respond to audit inquiries and provide supporting documentation as requested.

Other Duties as Assigned:

1. Administrative Support:
   • Provide general support to Special Services and Business Office as it relates to Medicaid billing.
   • Assist with data entry, file maintenance, and recordkeeping.
2. Process Improvement:
   • Identify opportunities to improve billing accuracy, efficiency, and compliance.
   • Support implementation of improved workflows and tracking systems.

Physical Demands:

• Regularly required to sit, talk, hear, and use hands and fingers to operate a computer and handle documents.
• Frequent use of close vision for reviewing detailed records and data.
• Ability to lift and move up to 15 25 lbs., such as files or office materials.

Working Conditions:

• Work is performed in an office environment with frequent interaction with staff and service providers.
• Requires sustained attention to detail and accuracy in a high-compliance environment.
• May require coordination across multiple departments and sites.