Reimbursement Analyst I

TX-HHSC-DSHS-DFPS•Austin, TX

4d•$4,523 - $5,889•Hybrid

About The Position

The Reimbursement Analyst I position performs work for the Provider Finance Department (PFD) under the supervision of the Director of the Payments Team. This position works with a team to ensure accuracy and compliance in the collection of intergovernmental transfers, administration of payments for supplemental or directed payment programs administered by PFD, and recoupments. The RAI works closely with RAIIIs and RAVs, but has considerable latitude for the use of initiative and independent judgment to ensure the proper operation of specific payment programs. Duties include: planning, review, development and implementation of payment processes, which may include coordinating with other teams within PFD and external stakeholders; reconciling data; designing or updating instructions / processes and procedures as needed; conducting data analysis to ensure accurate collection of local funding and issuance of payments; grant related work, and providing technical assistance to individuals both internal and external to the agency. This role develops, modifies, and maintains complex spreadsheets using large databases to perform payment analysis. The RAI may participate in the development of policy guidelines, recoupments letters, and other associated documents relating to payments and grants, as directed. This position is eligible for telework 3 days per week and in office 2 days per week; subject to change.

Requirements

Experience with Excel required.
Knowledge of accounting, business, and management principles, practices, and procedures.
Knowledge of state and federal laws and regulations relating to Medicaid reimbursement and public administration.
Skill in interpersonal relationships and in establishing and maintaining effective working relationships.
Skill in problem solving, identification of issues and development of creative solutions
Ability to analyze regulations, program policies, and issues.
Ability to exercise independent judgement, set priorities and meet deadlines.
Ability to communicate effectively both orally and in writing with a variety of agency staff, medical/provider associations, client advocates, legislative staff, lawyers, state/federal auditors, and interested parties on Medicaid reimbursement issues.

Nice To Haves

Graduation from an accredited four-year college or university is preferred, but not required. Work experience may be substituted for education on a one-to-one basis.

Responsibilities

Performs work on specific Medicaid supplemental and directed payment programs and recoupments.
Coordinates closely with the RAIII, assigned Team Lead and Director of the Payments Team to ensure program payment objectives are met in a timely and efficient manner.
Provides input to other analysts to develop and maintain consistency through standard procedures when processing payments.
Works collaboratively to collect, organize, analyze, and prepare materials in response to requests for information and reports.
Develops and implements recoupment letters for various supplemental payment and grant programs.
Designs and conducts research and analysis to evaluate recoupments by entity or grant initiative.
Develops, modifies, and maintains complex spreadsheets using large databases to perform grant recoupment analysis.
Under supervision, communicates high-level Medicaid program information to internal and external parties to provide, exchange, or verify information, answer inquiries, address issues or resolve problems or complaints.
Interfaces with various contracted providers, provider representatives, client advocates, other agency staff, advisory committees, workgroups, attorneys, and other interested parties concerning supplemental and directed payment programs.
Develops and implements data analysis to facilitate and coordinate payments for Medicaid programs.
Designs and conducts research and analysis to evaluate payments by entity or program initiative.
Develops, modifies, and maintains complex spreadsheets using large databases to perform payment analysis.
Develops and updates policy documents to clearly outline process steps, resources required, and instructions to be used for both staff training and audit responses as needed.
Makes recommendations to enhance existing processes and procedures to reflect best practices.
Performs other work as assigned or required to maintain and support the office and HHSC operations.