Remote PASRR Policy & Authorization Specialist

Texas Health and Human Services; Austin (TX); Hybrid; USD 50,000 - 66,000; Full time

Benefits offered by this job

Telework eligible

Job summary

Texas Health and Human Services Commission in Austin seeks a Program Specialist V to support PASRR specialized services review, adjudication, and authorization. You will interpret policies, assist providers, and ensure timely processing of claims related to PASRR services.

The role emphasizes collaboration, accuracy, and policy clarity, with telework eligibility and a focus on specialized services authorization. Strong analytical and communication skills are essential.

Qualifications

• Graduation from an accredited four-year college or university with major course work in a human services field.
• One year of relevant experience may be substituted for each year of required education.
• At least 2 years of experience in the IDD services field is preferred.
• Experience reviewing documentation, analyzing authorization or claims issues, and supporting resolution of complex payment concerns is preferred.

Responsibilities

• Review, adjudicate, and authorize requests for nursing facility specialized services and IDD habilitative services for PASRR-eligible individuals in nursing facilities.
• Provide technical assistance and policy clarification to external providers on PASRR procedures, policies, and rules.
• Assist with developing program and quality monitoring policies related to prior authorization of PASRR specialized services.
• Participate in work groups and TMHP LTC portal initiatives such as user acceptance testing (UAT).
• Complete other work as assigned by the PASRR Policy Manager or PASRR Specialized Services Lead.

Skills

PASRR knowledge

Claims processing concepts

Organizational skills

Analytical skills

Attention to detail

Communication skills

Microsoft Office

Independent & collaborative work

Excel

Education

Bachelor's degree in human services

Tools

TMHP LTC Online Portal

Microsoft Excel

Job description

Texas Health and Human Services Commission in Austin seeks a Program Specialist V to support PASRR specialized services review, adjudication, and authorization. You will interpret policies, assist providers, and ensure timely processing of claims related to PASRR services.

The role emphasizes collaboration, accuracy, and policy clarity, with telework eligibility and a focus on specialized services authorization. Strong analytical and communication skills are essential.