Customer Service Rep IV

FALL CREEK FARM & NURSERY; Austin (TX); Hybrid; USD 40,000 - 50,000; Full time

Benefits offered by this job

100% paid employee health insurance

Defined benefit pension

Generous time off benefits

Job summary

The Texas Health and Human Services Commission (HHSC) Medicaid & CHIP Services (MCS) unit seeks a Customer Service Representative in the Provider Claims Services (PCS) unit. This role reports to the PCS Program Supervisor and performs highly advanced customer service work in a call center environment dealing with Medicaid LTC providers and recipients.

The position involves researching and analyzing data across CARE, IDD Portal, SASO, TMHP LTC Portal, and a call tracking system to resolve claims

Qualifications

• Two years' experience in a call center or customer service environment.
• Preferred experience with Provider Claims Services systems.
• Preferred experience in researching and interpreting Medicaid policies and procedures.

Responsibilities

• Responds to inquiries regarding claims processing and billing issues for Medicaid LTC providers, recipients, agency case workers and eligibility staff via emails, reports, correspondence, or hotline.
• Researches and analyzes data within various automated systems to identify issues with claim processing/billing.
• Documents information in spreadsheets.
• Enters data, supporting records and actions taken to resolve billing or claims processing issues.
• Provides training to Medicaid providers on how to address or resolve issues in filing/processing claims.
• Interprets section policies and procedures for processing claims and service authorizations for LTC providers.

Skills

Customer service

Data entry

Microsoft Office

Communication

Tools

CARE

IDD Portal

SASO

TMHP LTC Portal

Call tracking system

Job description

Posting ID21341-Posted09/11/2026-Health & Human Services Comm-Provider Claims Svcs (75/25)-Office and Administrative Support-b. $3000 - $4999 per month

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage .

Functional Title:

Customer Service Rep IV

Job Title:

Customer Services Rep IV

Agency:

Health & Human Services Comm

Department:

Provider Claims Svcs (75/25)

Posting Number:

21341

Closing Date:

09/25/2026

Posting Audience:

Internal and External

Occupational Category:

Office and Administrative Support

Salary Range:

$3,581.33-$4,476.91

Pay Frequency:

Monthly

Salary Group:

TEXAS-A-17

Shift:

Day

Additional Shift:

None

Regular/Temporary:

Regular

Full Time/Part Time:

Full time

FLSA Exempt/Non-Exempt:

Nonexempt

Job Location City:

AUSTIN

Job Location Address:

701 W 51ST ST

Other Locations:

None

MOS Codes:

0100,0111,0170,4133,15P,3F1X1,3F5X1,420A,42A,56M,68G,741X,PERS,RS,SN,YN,YNS

Job Description:

Customer Services Rep IV The Texas Health and Human Services Commission (HHSC) Medicaid & CHIP Services (MCS) department seeks a highly qualified candidate for a Customer Service Representative in the Provider Claims Services (PCS) unit.

This position reports to the PCS Program Supervisor and performs highly advanced customer service work in a call center environment. Work involves contact with Medicaid Long Term Care (LTC) providers, Medicaid recipients, HHSC case workers and eligibility staff regarding filing claims for services and billing issues.

The position researches and analyzes complex data within multiple systems to resolve any issues and ensures claims continue to be processed accordingly. The position interprets section policies and procedures for filing claims for services provided under Hospice, Nursing Homes, Intermediate Care Facilities, and various waiver programs including Home and Community-based Services, Texas Home Living, Deaf Blind Multiple Disabilities, and Community Living Assistance and Support Services.

Essential Job Functions:

Responds to inquiries regarding claims processing and billing issues for Medicaid LTC providers, recipients, agency case workers and eligibility staff via emails, reports, correspondence, or hotline. Researches and analyzes data within various automated systems to identify issues with claim processing/billing. Documents information in spreadsheets. (45%)

Enters data, supporting records and actions taken to resolve billing or claims processing issues. Uses multiple systems including Client Assignment and Registration System (CARE), IDD Portal, Service Authorization System Online (SASO), Texas Medicaid and Health Care Partnership (TMHP) Long Term Care Portal, and a call tracking system. (35%)

Provides training to Medicaid providers on how to address or resolve issues in filing/processing claims. (10%)

Interprets section policies and procedures for processing claims and service authorizations for LTC providers. Collaborates with PCS coaches to resolve more complex claims/billing issues or provider concerns. (10%)

Registrations, Licensure Requirements or Certifications:

None required.

Knowledge Skills Abilities:

Skill in the use of standard office equipment.

Skill and experience resolving complicated billing issues promptly and efficiently. Experience utilizing Microsoft Office

Ability to apply policies and procedures and recommend changes. Ability to review problems and recommend solutions.

Ability to communicate verbally with stake holders.

Initial Screening Criteria:

Two years' experience working in a call center or customer service-oriented environment.

Preferred experience with Provider Claims Services systems.

Preferred experience in researching and interpreting Medicaid policies and procedures.

Additional Information:

A successful in-basket test results will determine progression to a scheduled interview.

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 tothose 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.