Administrative Asst IV - Reimbursement

Texas Health & Human Services Commission•CARLSBAD, TX

5d•$3,410 - $4,837•Onsite

About The Position

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. The state supported living centers serve people with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. The centers provide campus-based direct services and support at 13 centers located throughout the state. This is a career filled with purpose. Administrative Assistant IV will work in the Reimbursement Department. The Administrative Assistant IV position at San Angelo State Supported Living Center performs professional, technical, and administrative duties assisting in the operations of a facility-based reimbursement office. Performs new & ongoing redetermination for Medicaid and SSI benefits and monitors assessment of proper charges, maintenance of accounts receivable, and collection of charges for services provided by the facility. Works under the supervision of the Reimbursement Manager.

Requirements

Graduation from an accredited high school or possession of a GED.
Minimum of two (2) years of full-time work experience performing administrative support functions.
Demonstrated knowledge of health-related accounting frameworks, automated billing systems, and revenue collection procedures.
Proven understanding of federal and state laws, government regulations, and agency-specific rules governing service reimbursements.
Comprehensive knowledge of statutory criteria, policies, and documentation required to establish client eligibility for Medicaid and Supplemental Security Income (SSI) benefits.
Ability to rapidly absorb complex administrative processes, retain specialized healthcare reimbursement guidelines, and accurately apply database workflows with minimal oversight.
Ability to quickly comprehend evolving coding regulations, interpret dense departmental protocols, and maintain high data integrity.
Ability to work cohesively within a team environment while delivering high-quality, time-sensitive results under regulated deadlines.
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.
All applicants must be at least 18 years of age to be considered for employment at a state-operated facility.

Nice To Haves

Three (3) years of specialized experience utilizing Claims 2 system programs.
Three (3) years of hands-on experience working within the Trust Fund System.
Three (3) years of experience navigating and processing applications through TIERS and the State Portal.

Responsibilities

Reviews, evaluations, and processes complex financial documentation and applications to determine eligibility for Medicaid and Supplemental Security Income (SSI) benefits.
Utilizes automated data systems, including TIERS, the State Portal, Claims 2, and the Trust Fund System, to perform high-volume, accurate data entry, track claims, and maintain client records.
Executes health-related accounting, billing, and collection procedures in strict compliance with federal and state laws, government regulations, and agency rules.
Monitors, verifies, and reconciles agency service reimbursements, identifying discrepancies and ensuring compliance with regulatory frameworks.
Prepares detailed financial and administrative reports using Microsoft Word and Excel; collaborates seamlessly with internal team members and external stakeholders to meet rigid agency deadlines.
Performs activities to obtain financial information of individuals served: arranges and conducts interviews, composes correspondence, reviews relevant records, contacts knowledgeable sources.
Determines proper rates to be charged.
Performs determination and assessment of proper charges, maintenance of accounts receivable, and collection of charges for services provided by the facility.
Works with Individuals, guardians, and payor of such rates; reviews and adjusts charges as needed.
Performs activities to establish and maintain accounts receivable and enter transactions in the automated data system.
Performs various functions necessary to secure and maintain Medicaid eligibility for clients and collect Medicaid under the ICF/MR program: submits applications needed to establish Medicaid and SSI benefits and Forms 90-I; determines billing rates; maintains automated accounts; monitors and reports individuals' income, resource, and level-of-care information; reviews system reports and takes necessary action; maintains liaison with local representatives of Social Security and other agencies and provides assistance to families in the areas of forms completion, decision making.
Performs various functions necessary for the collection of Medicare Part B: secures documents containing medical service data; submits enrollment forms and claims; maintains automated system accounts; monitors and reports claims and collection data; maintains liaison with facility staff.
Performs various functions necessary to obtain and maintain client eligibility for Social Security and Supplemental Security Income benefits: research records; contacts knowledgeable sources; submits applications, reviews form, and other required documents; exchanges information with Social Security representatives.
Other related duties may be assigned.
Actively participating and/or serving in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or