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1.
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Ensure billing is in compliance with the
Texas Medicaid Healthcare Partnership (TMHP) guidelines by remaining
knowledgeable about the School Health and Related Services Program (SHARS)
requirements. |
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2.
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Contact daily the Texas Association of School Boards Medicaid Staff (TASB). |
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3.
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Facilitate training and information
exchange to TISD staff. |
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4.
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Keep current on SHARS Medicaid
policy, guidelines and regulations. |
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5.
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Develop a set of processes based
on the policy for Tyler Independent School District (TISD) staff. |
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6.
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Prepare and make presentation to
school district employees explaining the Medicaid guidelines and
regulations pertaining to the service they will be billing, including: |
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Diagnosticians |
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Psychologists |
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Speech Therapists |
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Nurses |
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Occupational Therapists |
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Physical Therapists |
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Audiologists |
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Life Skills Teachers and Aides |
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Bus Drivers |
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Special Ed. bus monitors |
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Counselors |
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7.
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Attend TASB and TMHP meetings and
workshops |
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8.
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Exhibit proficiency in all aspects of
the Site-Based Medicaid Administration Reimbursement Tracking (SMART)
software. |
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9.
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Maintain SMART database to ensure
billing information is correct by: |
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running student import |
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transmit data to TASB
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add new service providers |
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create default sessions for new
Medicaid Special Education students |
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maintain default sessions to
comply with the Individual Educational Plan (IEP) |
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10.
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Review IEP’s to assure all
billable services the student is receiving is billed. |
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11.
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Ensure the billable service is
written in the IEP to accurately generate revenue for the District by
using iWeb and insure revenue will not be recouped. |
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12.
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Download demographic information
of all Special Education students from iSeries into SMART system. |
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13.
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Upload students’ Medicaid
numbers to student file on iSeries monthly. |
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14.
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Communicating and working with
the Data Processing Department to ensure imports are working correctly. |
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15.
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Generate service tickets from SMART. |
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16.
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Customize service tickets, as
needed, for TISD from the SMART system. |
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17.
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Distribute tickets to staff at
their schools. |
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18.
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Monitor all service tickets returned to
insure all information is complete and correct. |
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19.
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Generate claims using SMART software.
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20.
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Follow-up and resubmit claims rejected
by TMHP for mismatched data using SMART system. |
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21.
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Generate financial and other reports as
needed. |
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22.
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File current Speech, Occupational
Therapy and Physical Therapy Physician referrals. |
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23.
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Deliver and pick up prescriptions from
Physician for Occupational Therapy, Physical Therapy in a timely manner
so Medicaid billing can start as soon as possible. |
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24.
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Review billing documentation to ensure
that it is acceptable and accessible for audits by Texas Education
Agency (TEA) and TMHP. |
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25.
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Gather data and assist in completing
audit requests. |
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26.
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Verify revenue amount, received by the
District from TMHP, balances with records on the SMART system. |
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27.
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Relieve TISD receptionist as needed. |
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28.
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Maintain positive and cooperative
working relationships with colleagues and others in the conduct of
district business; demonstrates teamwork in daily activities. |
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29.
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Maintain personnel and student
confidentiality in the conduct of district business. |
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30.
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Comply with district policies, state and
federal laws and regulations, as well as special education policies and
procedures. |
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31.
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Comply with directions and instructions
from supervisor and performs other tasks and assumes such
responsibilities as may be assigned. |
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32.
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Is prompt
and timely in completing daily tasks. |
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33.
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Complies
with “Expectations/Guidelines for the Special Education Department”. |