Medicaid Financial Consultant

Location Requirements: This role is Hybrid to one of our offices: Austin, Naperville or Wayne. Remote candidates will be considered.

Your role on the team:

The Medicaid Financial Consultant is a trusted partner to Frontline Educations Service Management and Medicaid clients. Reporting to the Medicaid Services Team Lead, this role is central to all client Medicaid revenue streams, including Medicaid Administrative Claiming, Cost Reporting and Fee-For-Service EDI transactions. This position will utilize their strong Medicaid Cost reporting, administrative claiming, EDI knowledge, communication, analytical and critical thinking skills to manage client Medicaid revenue and reporting in multiple states.

You can expect to:

• Develop success plans for clients that will result in revenue maximization and increased compliance.
• Define metrics for success, potential risks, and provide recommendations in line with client strategic revenue goals
• Maintain 100% retention and renewal rate of assigned client portfolio
• Maintain client relationships and regular client engagements to deliver revenue analysis

• Development and submission of annual cost reports, transportation cost reports and quarterly administrative claims reports in multiple states

• Develop success plans for Clients that outline critical success factors, metrics for success, potential risks, and provide recommendations in line with client strategic goals

• Maintenance of participatory lists for administrative claiming

• Monitor and manage client Medicaid revenue health for assigned base of clients/region

• Consult clients on potential Medicaid revenue and identify key areas for improvement; communicate regulatory updates to clients in a timely manner

• Support clients during state or federal audits to ensure all supporting documentation is supplied

• Meet quarterly and annual deadlines to produce all client cost reports, and administrative claims

• Work with claiming department to analyze denied or pended claims to assure adjudication

• Provide detailed analysis of provider documentation levels, claiming validations and impact on revenue

• Support clients during state or federal audits to ensure all supporting documentation is supplied

• Create upsell opportunities that expand revenue/solution growth

• Provide customer feedback channels such as product councils, user groups, and surveys to better understand the overall experience across all solutions

• Coordinate with implementation consultants to onboard new Medicaid customers

• Partner with CSM to act as a point of escalation for client satisfaction issues related to Medicaid revenue

• Help define SOW requirements and long-term project charters

• Review all Medicaid system reporting to ensure accuracy of results and identify anomalies in claiming or eligible levels that affect cost reporting or administrative claiming

• Analyze client financial information in excel and make recommendations on budgetary guidance to improve revenue

• Identify and escalate transaction issues to the team lead

• Work directly with the product department to communicate system enhancements for regulatory reasons

• Develop and present solution and professional service growth opportunities to deepen client relationship with Frontline

What you bring to the role:

• Ability to produce a trusted relationship with your clients while facilitating communications and interactions with Frontline Education at various levels of the business
• Ability to review and share Client feedback to improve the overall experience across all student documentation and Medicaid revenue solutions
• Ability to develop referenceable accounts
• Demonstrated ability to target critical business problems and apply appropriate decision making, technology, and best practice methodologies to resolve
• Capacity to develop a clear understanding of the business needs and translate them into solutions
• Ability to prioritize, multi-task, and perform effectively in ambiguous situations
• Ability to demonstrate a commitment to working through complex problems and complete tasks with a high level of accuracy and focus on satisfying the customer
• Ability to explain Medicaid announcements directly to clients regarding regulatory changes
• Ability to work independently and be self-motivated in a fast-paced environment

This role requires:

• Bachelor’s degree, or 6+ years of commensurate professional experience
• 2+ years of school-based Medicaid Cost Reporting and/or Administrative Claiming experience
• Proven ability to conduct financial analysis using excel and proprietary reporting tools
• Highly developed data analytical skills, advanced understanding of Excel
• Proven strong written and verbal communication skills
• Deep understanding of the state/district standards, policies, and processes
• Demonstrated ability to target critical business problems and apply appropriate decision-making, technology, and best practice methodologies to resolve

Who we are:

Frontline Education is a pioneer of school administration software purpose-built for K-12 districts. We provide innovative, connected solutions for student and special programs, business operations, and human capital management with powerful data and analytics to empower educators and administrators. We earn the trust of K-12 leaders across the U.S. by serving as a consistently high-performing, forthright partner of school districts through every dimension of the company.

We're a group of unique and talented individuals that love what we do. We've been lucky enough to land jobs with a rapidly growing tech company that supports an appreciative and friendly customer base. We work hard to make our customers happy, but we like to have a good time in the process. We are a company that strives to think in terms of “we” instead of “me.” We believe in the philosophy of servant leadership and that it’s all about putting others first. We also value the balance between family and work.

Frontline embraces diversity, equity, and inclusivity. We are intentionally building a workplace that respects, supports, and values the identities of all our employees. We believe this to be foundational in developing a strong community in our company. Frontline Education is an equal opportunity employer and we do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

The perks of being a Frontliner:

Frontline offers a competitive compensation package including a base salary, rewarding bonus structure, 401k match, and unlimited PTO! Our company growth has created a promising environment for career advancement and rewarding challenges. We offer a tuition reimbursement program for eligible college credit coursework available to employees depending on their status and length of employment.