Reimbursement Analyst I

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Job Description:

The Reimbursement Analyst I (RA I) performs consultative services, oversight, policy and datadevelopment, and technical analyses under the supervision of the Manager V for the Acute Care School-basedMedicaid Resource and Training team (SMRT) in the Provider Finance Department. This position will function as asubject matter expert in order to provide ongoing education to providers within this program. This position will beresponsible for a regionally designated group of Local Education Agency (LEA) providers and act as a key resourceand point of contact for those LEAs.This role involves daytime travel, approximately 75% of the work scheduled isdesignated to regions within the state. The LEA groups for this role are within El Paso, Lubbock, Midland, and Amarillo regions.

Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leavepolicy and performs other duties as assigned.
Provides technical guidance and support to LEAs participating in the SHARS program. Travels to all participatingLEAs within an assigned geographic region throughout the year to provide in person consultation and guidance.Analyzes annual key performance indicators to assist LEAs in maximizing federal reimbursement opportunities asparticipants in the program. (45%)
Provides guidance and training to direct service providers regarding eligible billing and claim submission based onprior year cost reported data. (10%)
Communicates complex information to LEA employed staff to provide, exchange, or verify information, answerinquiries, address issues or resolve problems or complaints. Interfaces with various contracted providers, providerrepresentatives, client advocates, other agency staff, advisory committees, workgroups, attorneys, and otherinterested parties concerning the SHARS program. (25%)
Develops and processes policy documents (including policy guidelines, agency rules, state plan amendments,council and advisory committee items, and workgroup materials relating to outreach and training for the SHARSprogram. (10%)
Performs other work as assigned or required to maintain and support the office and HHSC operations (10%)
This role will require traveling to several designated LEAs in the state. Selected candidates must physically reside within or be willing to travel to the designated LEAs on a frequent and regular basis.

Registrations, Licensure Requirements or Certifications: None Required

Knowledge Skills Abilities:

Knowledge of health and human service programs, services, and procedures.
Knowledge of accounting, business, and management principles, practices, and procedures.
Knowledge of state and federal laws and regulations relating to Medicaid reimbursement and publicadministration.
Knowledge of reimbursement methods and payment fees, formulas, and procedures.
Knowledge of claims processing and/or cost report review and completion.
Skill in the review of cost reports and processing of payments.
Skill in interpersonal relationships and in establishing and maintaining effective working relationships.
Skill in problem solving, identification of issues and development of creative solutions
Ability to analyze laws, regulations, program policies, and issues.
Ability to develop, evaluate, implement, and interpret policies, procedures, and rules.
Ability to use personal computers and to use word processing, spreadsheet, statistical, and other software todevelop payment rates.
Ability to exercise independent judgement, set priorities, meet deadlines, and adapt to shifting technical andpolitical developments.
Ability to manage projects effectively and produce quality work within short deadlines.
Ability to train staff on policies and procedures related to job functions.
Ability to lead other staff to accomplish department goals.
Ability to communicate effectively both orally and in writing with a variety of agency staff, medical/providerassociations, client advocates, legislative staff, lawyers, state/federal auditors, and interested parties on Medicaidreimbursement issues.
Ability to prepare well-written briefing documents and reports designed to convey complex detailed concepts.

Initial Selection Criteria: Graduation from an accredited 4-year college or university. Relevant experience may be substituted for education on a year to year basis.

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Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.