Texas Grant Utilization Reviewer

Community Medical Services•Austin, TX

About The Position

Community Medical Services (CMS) is hiring a Texas Grant Utilization Reviewer. Under the supervision of the Regional Operations Director, the Texas Grant Utilization Reviewer is responsible for monitoring Texas Grant Funded Client Tracker to ensure current client census is reflected, removing clients that have been discharged in a timely manner, and checking due dates and missing documentation for each client on funding and communicating updates needed to responsible staff and management. This position will travel to multiple CMS sites. As part of our mission to help individuals recover from substance use disorders, you’ll thrive in a supportive, engaging, and fulfilling work environment where your contributions are valued.

Requirements

High School diploma required plus relevant insurance verification experience
2+ years of front desk experience, preferably at hospital front desk or multi-physician practice
Proficient in an electronic medical record required, along with Microsoft Office Suite programs
Excellent organizational, problem-solving, time management and interpersonal skills
Ability to communicate clearly and effectively between all organizational levels and with outside providers
Advanced computer knowledge, including ability to navigate in electronic health records
General knowledge and aptitude for working independently with adults of mixed ethnic groups
Culturally competent and sensitive to client and employee needs
Excellent organizational skills, accuracy, and attention to detail
Problem solving, conflict resolution, time management, and strong customer service skills
Strong team player comfortable working in a fast-paced setting
Ability to maintain confidentiality to ensure compliance with HIPAA and 42 CFR, Part 2
Flexible with the ability to work in a continuously changing environment

Responsibilities

Monitoring Texas Grant Funded Client Tracker to ensure current client census is reflected, removing clients that have been discharged in a timely manner, and checking due dates and missing documentation for each client on funding and communicating updates needed to responsible staff and management.
Completing Daily Capacity Reports in CMBHS for each service location to ensure slots are not over capacity for funding and sending the report to the Regional Director.
Running Methasoft reports to compare against census, informing staff of discrepancies to resolve in timely manner including newly funded clients that need a change in billing episode.
Running GRPA reports weekly from CMBHS and sending them directly to managers showing which staff are due/overdue to increase compliance. (Have not run report from CMBHS, I’ve been checking each client’s chart) Run Report Called GPRA Client due for assessment.
Attending monthly GRPA webinar updates
Assisting other staff in trouble shooting errors, issues with service locations, revising documentation, etc.
Responsible for making contact in person or over phone to complete updates
Financial Eligibility with client (will make 3 attempts and document each prior to communicating need for other staff to assist with process.