STEP Care Manager

The School District of Philadelphia; Philadelphia (Philadelphia County); On-site; USD 54,000 - 72,000; Full time

Job summary

The School District of Philadelphia is seeking a STEP Care Manager within the Office of Prevention and Intervention. You will support the STEP program by ensuring regulatory compliance, coordinating pre-billing, and working with the STEP Leadership and Billing Specialist to optimize Medicaid reimbursements for behavioral health services.

You will review service documentation, manage authorizations in the Electronic Health Record, and liaise with district staff and external providers to maintain

Qualifications

• Bachelor’s degree from an accredited college or university.
• Two years of full-time admin support with Mental/Behavioral Health authorization & billing.
• Five years of admin support in Mental/Behavioral Health with CPT/ICD-10 coding.
• Combination of Mental/Behavioral Health experience acceptable to fill this Medicaid reimbursement position.
• Knowledge of CPT/ICD-10 coding and CBH Billing is preferred but not required.

Responsibilities

• Prepares and analyzes EHR reports to capture admissions and discharges for billing and data collection.
• Meets with STEP Leadership and STEP Teams to review policies and procedures.
• Reviews documentation for services rendered for completeness and accuracy.
• Ensures reimbursement requests meet eligibility requirements.
• Compiles requests for pre-authorization and manages authorizations in the EHR.
• Participates in examination of program records for regulatory compliance.
• Assists with data compilation and interdepartmental data as needed.
• Coordinates data exchange to determine student eligibility.
• Coordinates resolution of exception/error reports with Billing Specialist and STEP teams.
• Attends scheduled meetings.

Skills

CPT coding

ICD-10 coding

Compliance admin

Customer service

Mental/Behavioral Health forms

Education

Bachelor’s degree

Tools

Electronic Health Record

CBH Billing

Job description

Title:

STEP Care Manager

Department:

Office of Prevention and Intervention

Reports To:

Assistant Director, Operations (STEP)

Union:

Not Represented by a Union

Salary Range:

$53,848 - $72,484

The School District of Philadelphia is committed to becoming the fastest improving District in the country and transforming the educational opportunities it offers to our city’s more than 198,000 students. The District seeks leaders who have a passion for working with schools and communities who are committed to ensuring all students achieve. Serving a population as diverse as ours requires creativity, commitment and vision. Will you join us?

Job Summary:

The STEP Care Manager will work as part of the Support Team for Educational Partnership (STEP) to ensure that the STEP program remains in compliance with State and Funder regulatory requirements. Coordinates the pre billing functions of the STEP program with both STEP Leadership and the STEP Teams. The STEP Care Manager will coordinate with the STEP Billing Specialist to ensure that reimbursement procedures for Behavioral Health services provided to Medicaid-eligible students are being utilized and followed with integrity. Additionally, participates in the monitoring of the services rendered for compliance with State and Medicaid (CBH) reimbursement guidelines. Additional functions involve acting as a liaison with the District’s representatives and third party providers, as needed.

Essential Functions:

• Prepares and analyzes reports from the Electronic Health Record to capture new admissions and discharges from the STEP Program to ensure that students are set up completely and correctly to ensure seamless billing and data collection.
• Meets with STEP Leadership and STEP Teams to review policies and procedures and other program requirements as needed.
• Reviews documentation from STEP teams and providers for services rendered for completeness and accuracy.
• Assists in the assurance that the recommendation for service as well as the provider and type of service for which reimbursement is being sought meets the eligibility requirements.
• Compiles requests for submission for required pre-authorization and manages authorizations in the Electronic Health Record.
• Participates in the examination of program records as required to ensure compliance with State and Funder regulatory requirements.
• Assists with the compilation of interdepartmental data pertaining to the program as needed.
• Coordinates and assists with the exchange of data for the necessary parties to determine student eligibility.
• Coordinates the resolution of exception/error reports with the Billing Specialist, STEP Leadership, and STEP teams.
• Serves as a liaison between STEP Team and STEP Billing Specialist, as well as with other District employees and third party providers as needed.
• Attends scheduled meetings.

Minimum Requirements:

• Bachelor’s degree from an accredited college or university.
• Two years of full-time, paid experience in an administrative support role with Mental/Behavioral Health programs involving authorization management, compliance and review of records to ensure requests for medical reimbursements and health services comply with program guidelines as well as experience in Mental/Behavioral Health Billing, CPT, and ICD-10 coding. Experience with CBH Billing is encouraged, but not required.

OR

• Five years of full-time, paid experience in an administrative support role with Mental/Behavioral Health Programs involving authorization management, compliance and review of records to ensure requests for medical reimbursements and health services comply with program guidelines as well as experience in Mental/Behavioral Health Billing, CPT, and ICD-10 coding. Experience with CBH Billing is encouraged, but not required.

OR

• A combination of Mental/Behavioral Health experience determined to be acceptable by the Office of Talent to fill this Medicaid reimbursement position.

Knowledge, Skills And Abilities:

• Demonstrated knowledge of: o CPT and ICD-10 coding. o standard customer service practices and procedures. o the methods and techniques for effective compliance administration. o Mental/Behavioral Health forms and procedures.
• IBHS regulations, preferred.
• Ability to:
• work independently within an Electronic Health Record. o ensure Electronic Records meet documentation standards for regulatory requirements. o run reports and analyze program data. o create and utilize spreadsheets for compliance management.
• learn procedures pertaining to the STEP program. o communicate effectively, both orally and in writing.
• establish and maintain effective working relationships STEP leadership and STEP

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Nondiscrimination:

The School District of Philadelphia provides equal employment opportunities to all employees and applicants for employment without regard to race, color, age, creed, religion, sex, sexual orientation, ancestry, national origin, disability, pregnancy, marital status, gender identity, or genetic information. Please refer to Board Policy 348 for further information regarding the District's commitment to Nondiscrimination in Employment Practices

Primary Location:

Prevention & Intervention (9KR0)

Job:

Central Office

Schedule:

Regular

Employee Status:

Non-Management

Union Affiliation:

Not represented by a union

Overtime Status:

Exempt