Customer Services Rep Iv - Austin, United States - Health & Human Services Comm

Health & Human Services Comm

Verified Company

Austin, United States

2 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Customer Services Rep IV- This position reports to the PCS Program Supervisor and performs highly advanced customer service work in a call center environment.

Work involves contact with Medicaid Long Term Care (LTC) providers, Medicaid recipients, HHSC case workers and eligibility staff regarding filing claims for services and billing issues.

The position researches and analyzes complex data within multiple systems to resolve any issues and ensures claims continue to be processed accordingly. The position interprets section policies and procedures for filing claims for services provided under Hospice, Nursing Homes, Intermediate Care Facilities, and various waiver programs including Home and Communitybased Services, Texas Home Living, Deaf Blind Multiple Disabilities, and Community Living Assistance and Support Services.

Essential Job Functions:

Enters data, supporting records and actions taken to resolve billing or claims processing issues. Uses multiple systems including Client Assignment and Registration System (CARE), IDD Portal, Service Authorization System Online (SASO), Texas Medicaid and Health Care Partnership (TMHP) Long Term Care Portal, and a call tracking system. (35%)
Provides training to Medicaid providers on how to address or resolve issues in filing/processing claims. (10%)
Interprets section policies and procedures for processing claims and service authorizations for LTC providers. Collaborates with PCS coaches to resolve more complex claims/billing issues or provider concerns.

(10%)
Knowledge Skills Abilities:

Skill in the use of standard office equipment.

Skill and experience resolving complicated billing issues promptly and efficiently.
Experience utilizing Microsoft Office Excel spreadsheets.
Ability to review problems and recommend solutions.
Ability to communicate verbally with stake holders

Registration or Licensure Requirements:

None required.

Initial Selection Criteria:

Two years' experience working in a call center or customer service-oriented environment.

Preferred experience with Provider Claims Services systems.
Preferred experience in researching and interpreting Medicaid policies and procedures

Additional Information:

2. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual. 4. This position is eligible for partial telework in accordance with applicable HHSC policies. Some onsite work will be required.

MOS Code:

HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.