Program Specialist II — Reimbursement & Billing (Remote)

Socket.dev; Austin (TX); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Health insurance

Pension plan

Paid time off

Career advancement

Job summary

Texas Health and Human Services Commission in Austin seeks a Program Specialist II to provide complex technical assistance and consultative services to facility reimbursement staff. You will oversee Medicaid, Medicare, third party payors, and other claims activities while helping plan, implement and monitor reimbursement programs.

Telework is available three days a week, with a Monday–Friday schedule; the role offers advancement opportunities, a defined benefits pension, and 100% paid employee

Qualifications

• High school diploma/GED is 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 Texas Administrative Codes rules and regulations (preferred).

Responsibilities

• Provides oversight and support for maximizing revenues in reimbursement programs and resolves billing/payments issues.
• Maintains liaison with Medicare/Medicaid intermediaries and other entities to ensure proper claims processing and enrollment.
• Assists in policy development, procedures manual, and forms.

Skills

Outlook

Word

Excel

Communication skills

Accounts receivable

Reporting

Policy interpretation

Education

High school diploma or GED

Tools

Avatar EHR

Claim processing software

Job description

Texas Health and Human Services Commission in Austin seeks a Program Specialist II to provide complex technical assistance and consultative services to facility reimbursement staff. You will oversee Medicaid, Medicare, third party payors, and other claims activities while helping plan, implement and monitor reimbursement programs.

Telework is available three days a week, with a Monday–Friday schedule; the role offers advancement opportunities, a defined benefits pension, and 100% paid employee