Program Specialist II

FALL CREEK FARM & NURSERY; Austin (TX); Hybrid; USD 42,000 - 66,000; Full time

Benefits offered by this job

Telework three days a week

Job summary

Health & Human Services Commission in Austin seeks a Program Specialist II to provide complex technical assistance to facility reimbursement staff. The role oversees Medicaid, Medicare, and other third-party payor claims, ensuring efficient processing and revenue recovery.

The position requires knowledge of third-party payors, EHR systems such as Avatar, and the ability to analyze and implement reimbursement programs.

Qualifications

• High school diploma/GED (Required)
• Experience with third-party payors, Medicaid, and Medicare claims processing (Preferred)
• Experience with third-party credentialing processes and contracts (Required)
• Experience liaising with third-party payors to maintain contracts/credentialing (Preferred)
• Experience with internal desk audits of claim payments and denials (Preferred)
• Experience with the Texas Administrative Codes rules and regulations (Preferred)

Responsibilities

• Provides complex technical assistance and consultative services to facility reimbursement staff. Oversees Medicaid, Medicare, third-party insurances, and other claims activity.
• Assists in planning, analyzing, developing, implementing, monitoring, and problem solving for reimbursement programs.
• Completes third-party credentialing applications, assists with desk audits, and resolves issues with reimbursement staff.

Skills

Medicare Knowledge

Medicaid Knowledge

Private health insurance knowledge

Accounting procedures

Accounts receivable

Reporting

Communication skills

EHR systems (Avatar)

Outlook

Word

Excel

Education

High school diploma/GED

Tools

Outlook

Word

Excel

Job description

Additional Shifts available (1) - $3000 - $4999 per month

Functional Title:Program Specialist II

Job Title:Program Specialist II

Agency:Health & Human Services Comm

Department:Hospitals Section

Posting Number:21138

Closing Date:10/18/2026

Posting Audience:Internal and External

Occupational Category:Business and Financial Operations

Salary Range:$3,793.41-$5,921.25

Pay Frequency:Monthly

Salary Group:TEXAS-B-18

Shift:Day

Additional Shift:Days (First)

Telework:

Travel:Up to 10%

Regular/Temporary:Regular

Full Time/Part Time:Full time

FLSA Exempt/Non-Exempt:Nonexempt

Facility Location:

Job Location City:AUSTIN

Job Location Address:909 W 45TH ST #634 BLDG 4

Other Locations:None

MOS Codes:16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS

Program Specialist II provides complex technical assistance and consultative services to facility reimbursement staff located in the state hospitals. Provides oversight of Medicaid, Medicare, third party insurances and other claims activity performed by reimbursement staff. Assists in planning, analyzing, developing, implementing, monitoring, and problem solving for reimbursement programs. Position completes third party credentialing applications, assist with desk audits and resolving issues with reimbursement staff.

Knowledge, Skills, and Abilities Required

• Knowledge with various third-party programs such as Medicare, Medicaid, and private health insurance.
• Knowledge with health-related accounting and collection procedures.
• Knowledge with medical claims submission and reconciliation.
• Skills in advanced skills in using computer software, including but not limited to Outlook, Word, and Excel.
• Proficient in effectively managing, reconciling and/or reporting accounts receivables.
• Proficient in developing and/or implementing complex reporting specifications.
• Ability to communicate effectively verbally and in writing.
• Ability to learn how to interpret, and apply state and federal rules, regulations, policies and procedures.
• Ability to learn Electronic Health Records systems such as Avatar.
• Ability to establish and maintain effective working relationships with others.

Essential Job Functions (EJFs)

• Provides oversight, assistance and support for maximizing revenues in the reimbursement programs; and identifies and assists with resolving billing and payment problems. Collaborates with state hospital staff to resolve issues with Medicaid, Medicare or third party payors claims and initiates corrective action with appropriate agency on problems as needed. Advises Reimbursement staff on necessary action to obtain eligibility, claims processing and prevent loss of revenue.
• Maintains liaison with Medicare and Medicaid fiscal intermediaries, carriers, and other governmental and private entities to ensure successful and appropriate claims processing. Assists with Medicare and Medicaid Provider enrollment.
• Assists the development of policy, procedures manual, and special forms.

Registrations, Licensure Requirements or Certifications

“N/A”

Initial Screening Criteria

• High school diploma/GED (Required)
• Experience with third-party payors, Medicaid, and Medicare claims processing. (Preferred)
• Experience with Third-party credentialing processes and contracts. (Required)
• Experience Liaising with third-party payors to maintain the contracts/credentialing. (Preferred)
• Experience with internal desk audits of claim payments and denials. (Preferred)
• Experience with the Texas Administrative Codes rules and regulations. (Preferred)

Additional Information

Telework three days a week.

Position available Monday – Friday 8:00am to 5:00pm

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.