Reimbursement Analyst Iii - Houston, United States - Health & Human Services Comm

Health & Human Services Comm

Verified Company

Houston, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

The Reimbursement Analyst III (RA III) performs highly advanced (senior-level) consultative services, oversight, policy and data development, and technical analyses for the Provider Finance Department under the supervision of the Manager V for the Acute Care School Medicaid Resource and Training team (SMRT) in the Provider Finance Department.

This position will act as one of two team leads and will function as a backup to their supervisor for program matters.

This position will be responsible for a regionally designated group of Local Education Agency (LEA) providers and act as a key resource and point of contact for those LEAs.

The position works under mínimal supervision, with extensive latitude for the use of initiative and independent judgment.
This role involves daytime travel, approximately 75% of the work scheduled is designated to regions within the state's Educational Service Centers (ESC). The ESC regions for this role are within Victoria, Houston, Beaumont, and Huntsville.

Essential Job Functions:

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.

Provides technical guidance and support to LEAs participating in the SHARS program. Travels to all participating LEAs within an assigned geographic region throughout the year to provide in person consultation and guidance. Develops annual key performance indicators to assist LEAs in maximizing federal reimbursement opportunities as participants in the program. (45%)
Provides guidance and recommendations to other members of the team to develop recommendations for analyzing annual interim claims for payment to participating providers. Provides guidance and training to direct service providers regarding eligible billing and claim submission based on prior year cost reported data. (10%)
Communicates complex information to LEA employed staff 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 the SHARS program. (25%)
Develops and processes policy documents (including policy guidelines, agency rules, state plan amendments, council and advisory committee items, workgroup materials, and hearing other notices) relating to outreach and training for the SHARS program. (10%)
Establish schedule for statewide and provider specific trainings for the SHARS program. (5%)
Performs other work as assigned or required to maintain and support the office and HHSC operations (10%)
Knowledge Skills Abilities:Knowledge of health and human service programs, services, and procedures.
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.
Knowledge of reimbursement methods and payment fees, formulas, and procedures.
Knowledge of claims processing and/or cost report review and completion.
Skill in the review of cost reports and processing of payments.
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 laws, regulations, program policies, and issues.
Ability to develop, evaluate, implement, and interpret policies, procedures, and rules.
Ability to use personal computers and to use word processing, spreadsheet, statistical, and other software to develop payment rates.
Ability to exercise independent judgement, set priorities, meet deadlines, and adapt to shifting technical and political developments.
Ability to manage projects effectively and produce quality work within short deadlines.
Ability to train staff on policies and procedures related to job functions.
Ability to lead other staff to accomplish department goals.
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.
Ability to prepare wellwritten briefing documents and reports designed to convey complex detailed concepts.

Registration or Licensure Requirements:

None Required
Initial Selection Criteria:

Graduation from an accredited four-year college or university with a bachelor's degree in either social science; business, including accounting and statistics; economics; health-related field; political science; or other closely related field.

Experience may be substituted on a year for year basis. Experience in/with Medicaid and/or healthcare finance preferred.

Additional Information:

Requisition #

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