Texas Health and Human Services · 4 hours ago
Reimbursement Officer III- Statewide Billing Team
Terrell, TX
Contract
Onsite
Entry, Mid Level
$3,409.83/mo - $5,094.16/mo
2+ years expTexas Health and Human Services Commission (HHSC) is committed to making a positive impact on the lives of Texans. The Reimbursement Officer III will perform hospital patient reimbursement work, primarily involving billing for services provided to patients, while ensuring compliance with Medicaid regulations and addressing billing issues as they arise.
Health Care
No H1B
Responsibilities
Performs hospital patient reimbursement work, primarily work involves billing commercial insurance companies, Medicaid MCOs and Medicaid for charges for the support, maintenance, and treatment provided to hospital patients
Works under limited supervision, with considerable latitude for the use of initiative and independent judgment
Performs other duties as assigned
Attends work on a regular basis and may be asked to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned
Conducts reviews of patient files to ensure treatment complies with Medicaid regulations to ensure appropriate reimbursements for the all the hospitals in the state hospital system
Determines amounts to be charged for care and treatment based on treatment and care provided and terms of commercial insurance coverage or Medicaid rules
Determines proper payment, collection of charges, and issuance of payment on claims for all the state hospitals in the state psychiatric hospital system for commercial insurers, Medicaid MCOs and Medicaid
Establishes charges and creates claim batches in the electronic health records system
Resolves billing problems with electronic claim batches to ensure the submission of 'clean claims'
Performs other duties as assigned
Qualification
Required
Minimum of two (2) years of experience as a Reimbursement Officer II OR two (2) years of experience in the billing/reimbursement operations for a direct care provider
Knowledge of the principles of psychiatric hospital reimbursement and claim procedures, and of the rules and regulations for billing and claims for clinical services provided by the state
Skill in calculating obligations based upon a published set of rules or contract provisions; and in the use of general office equipment, computers, and applicable computer software
Ability to communicate effectively to ensure adequate clinical documentation for billings is obtained and provided as necessary to support claims
Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aid, Medication Aide and Employee Misconduct, List of Excluded Individuals/Entities (LEIE)
All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Waco Center for Youth applicants must be 21 years of age
Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours
Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required
Preferred
Experience In Billing For Inpatient Psychiatric Services Is Preferred
Experience with local, state, and federal laws and regulations relevant to a public entity is preferred
Benefits
100% paid employee health insurance for full-time eligible employees
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
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