Specialist, Third Party Billing (TPB)

Position Type:
LEAD - CENTRAL OFFICE PROFESSIONAL/SPEC, THIRD PARTY BILLING (V11170)

Date Posted:
2/19/2025

Location:
GREENWOOD BLDG E TPB (098514)

Closing Date:
02/28/2025BALTIMORE COUNTY PUBLIC SCHOOLS

CLASS TITLE: Specialist, Third Party Billing (TPB)

WORKING TITLE: Specialist, TPB Autism Waiver

TITLE CODE: V11170

SCHEDULE: Full Time

REPORTS TO: Manager, Third Party Billing

DEFINITION: Provides leadership, expertise, training, and assistance to Autism Wavier Facilitators/service coordinators (AWF), providers and others with respect to the Autism Wavier Program, Medicaid reimbursements and other state rules and regulations. Analyzes and develops program policies and procedures. Monitors and audits program compliance. Serves as a liaison between the Office of Third Party Billing, schools, offices, Maryland Department of Health (MDH), Maryland State Education (MSDE), and other related state agencies. Supervises autism waiver facilitators. Performs other duties as assigned.

EXAMPLES OF DUTIES:

• Coordinates third party billing autism waiver services provided by autism wavier facilitators.
• Provides advice, guidance, and consultation to AWFs regarding third party billing and related matters. Receives and responds to questions and inquiries from AWFs, service providers, state agencies and parents.
• Develops, revises, and produces training materials such as written guides, booklets, and manuals. Schedules and conducts AW training workshops for schools, offices and parents.
• Reviews results from the Autism Waiver self-monitoring, and the Interagency Medicaid Monitoring Team, state audits. Analyzes monitoring results to determine when technical assistance is needed for autism waiver facilitators.
• Reviews and monitors autism wavier services data and other materials submitted by AWFs. Ensures that AW forms, and other related information 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 autism wavier service record entries. Conducts internal audits.
• Prepares reports which measure reimbursement and other program indicators. Keeps current with Medicaid laws and regulations.
• Analyzes and monitors autism waiver processes strategies, systems and operations. Assists and coordinates various automation and operational improvement initiatives.
• 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.
• Plans and provides technical guidance in the implementation, maintenance, and enhancements of Autism Waiver section of the Third Party Billing automated billing systems and associated software and equipment. Trains AWFs 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.
• Confers with users. Provides advice and guidance to departmental management regarding automation and operational issues. Represents the office in meetings and on committees.
• Assists with overall coordination between waiver participants, service providers, case managers, service coordinators, and service providers. Monitors and reviews caseload of the autism waiver service coordinators.
• Assists families in completing and submitting waiver applications and related documents to the Maryland State Department of Education and the Department of Health and Mental Hygiene.Determines the
• Provides Autism Waiver service coordination to eligible children and their families. Updates participant Plans of Care as needed, collaborates with school psychologist to facilitate the annual redetermination of Waiver eligibility for each student and participates in meetings with participant families.
• Implements and monitors procedures for the Autism Waiver as set forth in COMAR.Completes risk assessments as needed and reviews and responds to Reportable Events.Provides crisis intervention support and consultation regarding Waiver services.
• Maintains accurate, accessible records to meet state and federal requirements.Monitors billing and payment procedures for service providers and agencies.
• Works with colleagues and MSDE to identify additional billing options per COMAR regulations and analyze any discrepancies between agencies.

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, systems analyst, or master's degree equivalency. Experience with Autism Waiver program, 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.

CONDITIONS OF EMPLOYMENT:
N/A

GRADE: 07/OPE

SALARY: $84,696 to $133,558 (Annual Salary Scale for Exempt 12-Month Employees Represented by BCPSOPE 2024-2025 Effective July 1, 2024)

OTHER COMPENSATION: This position may be eligible for comp time. Visit the BCPS website to review the OPE Master Agreement for additional information at https://www.bcps.org/cms/One.aspx?portalId=2828&pageId=69996497.

FLSA: Exempt

RETIREMENT: Eligible for the Baltimore County Employees' Retirement System.

BENEFITS: BCPS offers a comprehensive benefits program for eligible employees including options for medical plans, dental plans, vision, life insurance, flexible spending accounts, disability coverage, and 403(b)/457 plans. Other benefits include paid vacation, paid holiday's, sick, personal business, and bereavement days, and flexible leave options such as FMLA, sick bank, and board approved leaves. All new hires will attend a benefits meeting upon hire.

Visit the BCPS website for additional information about benefit plans for BCPS employees at
https://www.bcps.org/hr/compliance/benefits_and_retirement

This document describes the duties and responsibilities of a position or group of positions. 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 (per COMAR) completed. The fee charged for fingerprinting is $109. 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 will be required upon hire and must be sent via escript/clearinghouse from your university.
• Some positions will require employees to undergo a physical examination and/or drug testing.
• All newly hired personnel must attend a Benefits and Retirement Orientation meeting.
• Additional job verification may 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, 9600 Pulaski Park Drive, Suite 118, Baltimore, MD 21220 (443-809-4360).

Contact Information
Shawn Stahl
Manager, Office of Staffing
6901 Charles Street, E Building
Towson, Maryland 21204
Phone: 443-809-7872
Fax: 410-296-0568
Email: sstahl@bcps.org