Strategic Revenue Management Specialist IV

Texas A&M International; Austin, Northern (TX, KY); Hybrid; USD 48,000 - 62,000; Full time

Job summary

The Texas Health and Human Services Commission invites applications for a Program Specialist IV in Revenue Management based in Austin. The role supports complex reimbursement programs across SSLCs and state facilities, develops policies, analyzes data, and ensures accurate billing and reporting for Medicare, Medicaid and other programs.

Responsibilities include guiding staff, training reimbursement officers, and coordinating with HHSC and external agencies to resolve issues, implement

Qualifications

• Experience with automated or billing systems.
• Experience with reconciling or reporting accounts receivable.
• Experience with federal and state laws and regulations affecting third-party and non-third party reimbursement for services.
• Experience with various third-party programs such as Medicare, Medicaid, and private health insurance.

Responsibilities

• Plans and directs MR Reimbursement program development and implementation in State Office and out-stationed Reimbursement offices located in 13 State Supported Living Centers (SSLCs).
• Reviews/researches State and Federal laws, rules, and regulations for impact on reimbursement; plans, develops, implements, coordinates, maintains, and interprets, policies, procedures, and standards for ICF/IID Reimbursement program; and develops and maintains procedures and reports related to the use of the Claims2 Automated Patient Billing System.
• Identifies operational problems and provides assistance to Reimbursement Office staff in resolution of problems; interacts with management, staff, or customers to answer inquiries, discuss problems, develop resolutions, and report to management on status and issues; and coordinates with Internal Audit, Center for Policy and Innovation, ID facilities, and other agency management/staff on issues that impact SSLC revenue.
• Provides instruction and guidance on reimbursement to managers and staff and provides training to all Reimbursement Officers on all facets of billing and collection of revenue.
• Serves as liaison with HHSC, Social Security Administration, other agencies management and staff to coordinate program activities and resolve problems and represents the agency at meetings, conferences, committees, workgroups, and hearings to address significant issues.

Job description

The Texas Health and Human Services Commission invites applications for a Program Specialist IV in Revenue Management based in Austin. The role supports complex reimbursement programs across SSLCs and state facilities, develops policies, analyzes data, and ensures accurate billing and reporting for Medicare, Medicaid and other programs.

Responsibilities include guiding staff, training reimbursement officers, and coordinating with HHSC and external agencies to resolve issues, implement