Financial Examiner V

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, and numerous opportunities for career advancement.

About the role

The Financial Examiner V position serves an integral function within the Provider Finance Department (PFD) by performing highly complex (senior-level) financial examinations of cost reports and financial compliance reports. This includes performing peer reviews and quality assurance evaluations of completed financial examinations to determine financial condition, level of internal controls, and compliance with examination requirements. The examinations ensure the accuracy and reasonableness of cost and statistical data used to support established reimbursement rate methodologies, cost determination, and payment adequacy evaluations for certain Medicaid and non-Medicaid services.

Financial examinations are performed in accordance with the Texas Administrative Code, program-specific cost report instructions, generally accepted accounting principles (GAAP), and state and federal regulations. The role involves reviewing Medicaid and non-Medicaid contracted providers’ submitted reports and supporting documentation, such as trial balances, general ledgers, allocation worksheets, payroll data, and other records. The Financial Examiner may confer with management staff to resolve issues, coordinate with internal colleagues, or contact providers to request clarification or additional documentation. They may also testify in hearings and court proceedings as an expert witness.

The examination process includes planning, scheduling, coordinating, conducting, and reporting results. Work is performed with limited supervision, with considerable latitude for the use of initiative and independent judgment.

Responsibilities

• Performs financial examinations and peer reviews of financial compliance and cost reports, including financial data, statistical data, and supporting documentation. Ensures examinations are completed in accordance with department policies and within assigned timeframes. (55%)
• Manages workload by planning and organizing to ensure peer reviews and examinations are completed within PFD-established deadlines. (15%)
• Communicates with management staff, internal agency staff, contracted providers, financial contacts, and cost report preparers on peer review and quality assurance findings. Prepares and issues reports, correspondence, and deliverables in a timely and accurate manner. (15%)
• Assists in evaluating examination processes; identifies areas of progress, improvement, or concern; makes recommendations; and assists in implementing new processes and resolving problems. (10%)
• Completes additional or special projects as assigned by the Manager or Director. (5%)
• Attends work on a regular and predictable schedule in accordance with agency leave policy.

Requirements

• Minimum of 5 years of experience in financial examinations, financial operations, financial analysis, data analysis, budgeting, accounting, bookkeeping, auditing, Medicaid reimbursement, or cost reporting.
• Demonstrated experience in conducting peer reviews or quality assurance practices in financial examinations or financial analysis is preferred.
• Graduation from an accredited four-year college or university with major coursework in accounting, business administration, finance, economics, or a related field is preferred. Relevant financial examination, accounting, or audit experience may substitute for education on a year-to-year basis.
• Candidates certified as a CPA, CIA, CGAP, CIGA, CFE, and/or CISA are preferred.

Skills

• Knowledge of Generally Accepted Accounting Principles (GAAP), Texas Administrative Code, and applicable rules and regulations.
• Knowledge of office management practices, administrative procedures, accounting methods, and accounting systems.
• Knowledge of HHSC programs, services, and procedures.
• Skill in critical thinking, gathering, analyzing, and making accurate decisions about information.
• Skill in numerical, verbal, and written communication, and research.
• Proficiency in MS Office applications, with intermediate to moderate skill in Microsoft Excel.
• Ability to conduct financial examinations, set priorities, plan, organize, and coordinate work activities.
• Ability to learn and work on multiple complex projects, understand cost allocation methods, and apply allocation ratios to different programs.
• Ability to maintain effective working relationships with others (teamwork).
• Ability to analyze financial records and other reports to support the financial examination process.
• Ability to interpret and implement policies and procedures.
• Ability to manage multiple projects effectively and produce quality work to meet deadlines.
• Ability to concentrate for extended time periods on detailed documents or projects.

Benefits

• 100% paid employee health insurance for full-time eligible employees.
• Defined benefit pension plan.
• Generous time off benefits.
• Numerous opportunities for career advancement.

Pay

Salary Range: $5,797.66 - $9,508.25 per month.

Schedule

• Full-time, regular position.
• Day shift.
• Eligible for telework, with a requirement to work in-office twice a week at the North Austin Complex.
• Up to 5% travel may be required.