Program Specialist II - Reimbursement & Claims (Remote)

Texas Health and Human Services; Austin (TX); Hybrid; USD 42,000 - 66,000; Full time

Benefits offered by this job

100% paid employee health insurance (f

Defined benefit pension plan

Generous time off benefits

Career advancement opportunities

Job summary

Texas Health and Human Services in Austin seeks a Program Specialist II to provide complex technical assistance and consultative services to facility reimbursement staff. You will oversee Medicaid, Medicare, and other payors, and assist in planning, analyzing, and implementing reimbursement programs.

The role requires knowledge of third-party programs, strong accounting and reporting skills, and experience with EHR systems like Avatar.

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 preferred.

Responsibilities

• Provides oversight to maximize revenues in reimbursement programs and resolve billing and payment issues.
• Collaborates with state hospital staff to resolve Medicaid/Medicare or third-party payor issues and initiates corrective action.
• Assists in policy development, procedures manuals, and special forms.

Skills

Medicare knowledge

Medicaid knowledge

Health insurance claims processing

Outlook

Word

Excel

Accounts receivable

Reporting specifications

EHR Avatar

Policy interpretation

Education

High school diploma or GED

Tools

Avatar EHR system

Job description

Texas Health and Human Services in Austin seeks a Program Specialist II to provide complex technical assistance and consultative services to facility reimbursement staff. You will oversee Medicaid, Medicare, and other payors, and assist in planning, analyzing, and implementing reimbursement programs.

The role requires knowledge of third-party programs, strong accounting and reporting skills, and experience with EHR systems like Avatar.