Manage MediCal and CYBHI billing, ensure regulatory compliance, submit and reconcile claims, conduct audits, train staff, improve reimbursement workflows, and report reimbursement activity to finance and leadership.
At Rocketship Public Schools, we believe in the infinite possibility of human potential. We believe that every student deserves the right to dream, to discover, and to develop their unique potential and it is our responsibility and our privilege to unleash the potential inside every Rocketeer we serve. Our non-profit network of public elementary charter schools propels student achievement, develops exceptional educators, and partners with parents who enable high-quality public schools to thrive in their community. We are a collective of parents, teachers, leaders, and students working together to transform the future for underserved communities across our country. At Rocketship Public Schools, we are unleashing potential.
Position Overview
As the Related Services Billing & Compliance Coordinator, you will hold a pivotal role in ensuring that all MediCal and Insurance related processes and reimbursements within the regional team are executed with the highest level of accuracy, compliance, and efficiency. You will collaborate with school operations, finance, and external partners to safeguard Medical & CYBHI (California Youth Behavioral Health Insurance) compliance, ensuring that all eligible services provided to students are appropriately documented and reimbursed. Your expert knowledge of reimbursement protocols and regulatory guidelines will help optimize financial processes and drive the success of our schools. This is a grant funded position and may be reassessed annually.
The following are key responsibilities related to the position:
MediCal Compliance Leadership
- Ensure that all MediCal billing and documentation processes are compliant with federal and state regulations.
- Monitor changes in MediCal regulations and guidelines, ensuring all school staff are trained on updates and procedures.
- Oversee the preparation, submission, and follow-up of MediCal claims, ensuring accuracy and timely processing.
Reimbursement Management
- Manage the reimbursement process for services provided to eligible students, ensuring that all claims are filed correctly and promptly.
- Conduct regular audits of reimbursements to ensure compliance with both internal policies and external regulations.
- Serve as the primary point of contact for any reimbursement-related inquiries, including communication with insurance providers, MediCal representatives, and school staff.
- Reconcile reimbursement accounts, ensuring all payments are processed, tracked, and documented appropriately.
Process Improvement Efficiency
- Identify areas for process improvement within the MediCal billing and reimbursement workflow.
- Develop and implement strategies for streamlining the reimbursement process, reducing errors, and improving turnaround times.
- Lead initiatives to enhance the overall efficiency of compliance and reimbursement procedures across the regional network.
Training & Support
- Provide training and ongoing support to school staff and regional team members on MediCal compliance and reimbursement best practices.
- Ensure staff is equipped with up-to-date resources and knowledge on MediCal eligibility, services covered, and billing procedures.
Collaboration & Reporting
- Work closely with the finance and operations teams to ensure that MediCal-related revenue is properly reflected in school budgets.
- Prepare detailed reports on reimbursement activities, compliance status, and potential areas of concern for senior leadership.
- Assist with any audits or reviews related to MediCal compliance and reimbursement, providing requested documentation and explanations.
Qualifications
- Education: Bachelor’s degree in Finance, Business Administration, Healthcare Administration, or a related field.
- Experience:
- Minimum of 3 years of experience in MediCal billing, reimbursement, or compliance, preferably in an educational or healthcare setting.
- Strong understanding of federal and state MediCal regulations and compliance requirements.
- Previous experience working in public schools or charter schools is a plus.
- Skills & Competencies:
- High attention to detail with the ability to manage large volumes of data accurately.
- Exceptional communication skills, both written and verbal.
- Strong organizational skills with the ability to prioritize tasks effectively.
- Ability to work independently and collaboratively in a fast-paced environment.
- Proficiency with reimbursement software and systems (e.g., MediCal billing software, spreadsheets, etc.).
- Problem-solving mindset and ability to navigate complex regulations.
Working Conditions
- This is an hourly, full-time position with a flexible schedule, typically requiring 40 hours per week.
- Some evening or weekend work may be required to meet deadlines or address urgent issues.
- The role involves working both remotely and in-office, with occasional travel to school sites for training or compliance reviews.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. While performing the duties of this position, the employee is regularly required to talk, hear, and communicate with both adults and children. The employee frequently is required to use hands or fingers, handle or feel objects, tools, or controls. The employee is frequently required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 50 pounds and occasionally climb ladders. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is moderate to high.
Compensation:
Commensurate with qualifications and experience, plus excellent health and wellness benefits, 403b retirement plan, flexible spending account (FSA), and generous paid time off.
Rocketship Public Schools provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Rocketship Public Schools complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Rocketship Public Schools expressly prohibits any form of unlawful employee harassment based on race, color, religion, gender, sexual orientation, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Rocketship Public Schools’ employees to perform their expected job duties is absolutely not tolerated. Click here for our Sexual Harassment Policy. For questions, concerns, or complaints, please contact Human Resources.
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