Texas Health and Human Services · 2 hours ago
Reimbursement Officer
Richmond, TX
Contract
Onsite
Mid, Senior Level
$3,793.41/mo - $5,921.25/mo
2+ years expTexas Health and Human Services Commission (HHSC) is committed to creating a positive impact in the lives of fellow Texans. The Reimbursement Officer IV plans, directs, and monitors the activities of the Reimbursement office for services furnished by ICF/IID facilities, performing advanced reimbursement claims processing work and managing the reimbursement office operations.
Health Care
Responsibilities
Performs various activities necessary to collect Medicaid under the ICF/ID program: completes and submits applications and Forms 90-I; calculates billing rates; maintains accounts in automated mainframe data system; monitors and reports changes in individuals' income, resources, and level of care to Texas Health and Human Services and Social Security; and calculates monthly work earning budgets. All activities conform to established procedures as stated in the ID Reimbursement Policy and Procedure Manual
Performs various activities necessary to enter non-third-party financial transactions into the automated data system. All activities conform to established procedures as stated in the ID Reimbursement Policy and Procedure Manual
Completes application process for benefits from Social Security, Supplemental Security Income, VA, Civil Service and Railroad programs on behalf of individuals with potential eligibility. All activities conform to established procedures as stated in the ID Reimbursement Policy and Procedure Manual
Performs various activities necessary to maintain Medicaid eligibility; completes all required Medicaid eligibility forms; Form 1200-PFS, PFS-2, SSA-454, and SSA-455. All activities conform to established procedures as stated in the ID Reimbursement Policy and Procedure Manual
Performs office functions, including maintenance of files, distribution of daily mail, answering telephone, greeting visitors, work processing and photocopying documents. All activities conform to established procedures as stated in the ID Reimbursement Policy and Procedure Manual
Reviews of VPS system reports and takes necessary action. All activities conform to established procedures as stated in the ID Reimbursement Policy and Procedure Manual
Monitors various activities necessary to collect Medicare Part B reimbursement for physicians' services including consultation and surgery and ancillary services including lab, radiology, EEG, EKG, vaccines, injections, and venipunctures. All activities conform to established procedures as stated in the ID Reimbursement Policy and Procedure Manual
Performs and/or oversees staff engaged in financial interviewing, financial investigations, asset research, and fee determinations
Performs related work as assigned
Assesses training needs based on observations and monitoring of reimbursement programs
Interprets, establishes, and implements policies and procedures
Resolves billing problems and financial determinations
Qualification
Required
Experience in claims processing and health-related account and collection work
Bachelor's degree from an accredited college or university with major course of study in business administration or related field, and two (2) years responsible progressive experience in health-related account and collection procedures with supervisory experience; or high school graduation or equivalent and three (3) years' work experience in a related field involving administrative and technical responsibilities
Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide and Employee Misconduct and HHS List of Excluded Individuals/Entities (LEIE)
Males between the ages of 18 – 25 must be registered with the Selective Service
All State Supported Living Center Employees are subject to Random Drug Testing
Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours. Must be willing to work weekends and holidays
All applicants must be at least 18 years of age to be considered for employment at a state-operated facility
Benefits
100% paid employee health insurance for full-time eligible employees
A defined benefit pension plan
Generous time off benefits
Numerous opportunities for career advancement
Company
Texas Health and Human Services
Texas Health and Human Services is an agency that focuses on improving health, safety and well-being.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Dr. Napoleon Broughton
Chief Executive Officer: Life Enhancement Solutions
John F. Palermo
CTO Strategic Analyst VI
Recent News
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2025-04-09
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2024-04-01
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