Senior Medicaid Coding & Policy Specialist

Texas Health and Human Services; Austin (TX); On-site; USD 50,000 - 81,000; Full time

Benefits offered by this job

Health insurance

Pension plan

Time off

Career advancement

Job summary

The Texas Health and Human Services Commission (HHSC) seeks a Program Specialist V in Austin to advance Medicaid medical benefits policy, focusing on clinical billing and coding guidance and regulatory research. You will analyze CPT, HCPCS, NCCI and ICD impacts and help shape policy changes with strong written and oral communication.

You will collaborate with HHSC staff and external stakeholders, provide training, and prepare policy updates for leadership.

Qualifications

• Experience in clinical billing and coding is required.
• Experience in oral and written communication, applying analytical skills and evidence of successfully leading previous projects.
• Graduation from an accredited four-year college or university.

Responsibilities

• Researches, analyzes, and synthesizes Medicaid medical benefit policy, regulations, client information, and claims processing data with focus on coding and billing.
• Participates and may lead in development/implementation of new or revised medical benefit policies and collaborates with HHSC staff and other agencies.
• Provides training and guidance on clinical coding and billing, responds to inquiries, and prepares policy updates and reports.
• Participates in public meetings or workgroups to evaluate medical benefit issues and ensures TMPPM materials are accurate.
• Assists in developing memos and briefings for HHSC leadership and supports colleagues in policy development.

Skills

HCPCS

CPT

NCCI

ICD

Written communication

Oral communication

Policy analysis

Project management

Microsoft Office

Education

Bachelor's degree

Tools

Microsoft Office

Job description

The Texas Health and Human Services Commission (HHSC) seeks a Program Specialist V in Austin to advance Medicaid medical benefits policy, focusing on clinical billing and coding guidance and regulatory research. You will analyze CPT, HCPCS, NCCI and ICD impacts and help shape policy changes with strong written and oral communication.

You will collaborate with HHSC staff and external stakeholders, provide training, and prepare policy updates for leadership.