Medicaid Specialist



Perform a full range of tasks that support the Winchester Public Schools Medicaid program. Serve as the primary point of contact for all Medicaid program activities.


The successful candidate will be responsible for the following:

  • Develop procedures pertaining to Medicaid documentation and reimbursement and ensures FERPA and HIPPA compliance;
  • Develop procedures for identification of Medicaid-eligible students;
  • Interface with staff to obtain parental consent forms;
  • Interface with federal, state, local and private agencies to obtain information about eligible students;
  • Monitor federal, state and licensing boards regulations pertaining to the Medicaid and Schools program
  • Review applicable laws and regulations
  • Prepare, maintains and reviews all student Medicaid files;
  • Analyze documentation in case files for accuracy, follow-up and changes in status;
  • Coordinate all billable services (i.e. nursing, personal care, psychological, speech, physical and occupational therapy services and transportation); Creates, maintains, and provides supporting documentation and provider qualifications; submit all billing
  • Analyzes plans of care, addendums, discharge, note documentation and billing information;
  • Act as Winchester Public Schools liaison with appropriate state agencies;
  • Collaborates with the Department of Technology to manage the Medicaid database and security;
  • Develop and maintains billing program for reimbursement of services;
  • Reconcile accounts and responds to billing discrepancies;
  • Train providers regarding compliance with Medicaid requirements and procedures;
  • Prepare and reviews program-related correspondence;
  • Create procedural protocols for the local implementation of Medicaid reimbursement program;
  • Coordinate and monitor the Administrative Claiming Program (including quarterly time study);
  • Stay abreast of changes and developments in the Medicaid reimbursement program and attend Medicaid meetings conducted by state, federal agencies and the National Alliance of Medicaid in Schools (NAME);
  • Collaborate with Finance, Special Education and Health Services and Transportation departments to obtain information on Medicaid-related activities as needed for Cost-Based Reimbursement; Complete quarterly ACC reports, yearly school based services and transportation cost reports;
  • Develop and maintain database to track children and their Medicaid eligibility
  • Submit billing
  • Perform related work as required and keep up with ever changing Federal Medicaid rules and regulations;


Experience in providing support in the area of medicaid related issues.


Winchester Public Schools Central Administrative Offices


Salary range is $16.17 – $34.69 per hour


Part-time, 6 hours per day, Monday – Friday

Start Date:

Upon Hire


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