Health Care Recipient Billing Analyst - Human Services Program Specialist 2

About the role

The Minnesota Department of Human Services (DHS) is seeking a highly skilled and detail-oriented Health Care Recipient Billing (HCRB) Analyst to support the administration of Minnesota Health Care Programs (MHCP). This position plays a critical role in ensuring the accurate billing of premiums, fees, and spenddowns that allow Minnesotans to maintain access to essential health care coverage.

The Health Care Recipient Billing (HCRB) team is responsible for maintaining recipient billing accounts and ensuring the accurate invoicing of premiums, fees, and spenddowns for the following Minnesota Health Care Programs:

• Medical Assistance for Employed Persons with Disabilities (MA-EPD)
• MinnesotaCare for Deferred Action for Childhood Arrivals (DACA)
• Alternative Care (AC)
• Minnesota Senior Health Options (MSHO)
• Special Needs Basic Care (SNBC)

The HCRB team collaborates with counties and tribal agencies, Health Care Eligibility Operations (HCEO), the Financial Operations Division (FOD), Minnesota Management and Budget (MMB), and other stakeholders to support accurate billing and eligibility determinations while providing direct customer service to consumers and MHCP staff.

Responsibilities

• Serve as a Billing Subject Matter Expert
  • Apply federal and state regulations, policies, and procedures governing MHCP billing programs.
  • Provide clear and accurate guidance to staff, stakeholders, and partners regarding billing requirements and account maintenance.
  • Ensure billing activities are completed accurately, timely, and in compliance with program requirements.
• Provide Technical and Operational Support
  • Create reports, organize, coordinate, and support daily HCRB operations.
  • Serve as a technical resource for team members and supervisors by providing consultation, training, policy interpretation, and billing guidance.
  • Identify trends, risks, and operational issues and recommend solutions.
• Resolve Complex and Escalated Billing Issues
  • Act as the escalation point for complex billing accounts and customer concerns.
  • Research, analyze, and resolve account discrepancies involving multiple systems and stakeholders.
  • Ensure timely and accurate resolution of priority inquiries while maintaining excellent customer service.
• Improve Business Processes and Program Operations
  • Participate in projects focused on process improvement, operational efficiency, and compliance.
  • Recommend enhancements to billing procedures, workflows, and system functionality.
  • Support testing, implementation, and monitoring of systems and policy changes impacting recipient billing.

Requirements

Three (3) years of health care eligibility and systems experience demonstrating:

• Knowledge of public health care programs and policies, such as Medical Assistance and related health care programs.
• Accounting or financial experience sufficient to process accounts receivable, reconcile account discrepancies, and ensure accurate billing activity.
• Knowledge of federal and state statutes, rules, regulations, and operational procedures governing health care eligibility and billing programs.

Qualifications

Preferred Qualifications

• Advanced experience navigating and utilizing systems such as MAXIS, MMIS, SWIFT, SRU, CRM, FileNet, and SharePoint.
• Experience working with Minnesota Health Care Programs and recipient billing policies and processes.
• Experience analyzing and interpreting billing, financial, eligibility, or operational data using tools such as SQL, Teradata, Excel, Access, or enterprise data warehouses.
• Experience with coaching, mentoring, training, and providing guidance to staff.
• Strong analytical and problem-solving skills with the ability to research, interpret, and apply policy to complex situations.
• Effective written and oral communication skills sufficient to explain technical information to diverse audiences and provide customer service in challenging situations.
• Project management experience leading process improvement initiatives or participating in operational projects.
• Experience working effectively with individuals from diverse backgrounds, cultures, and communities.

Additional Requirements

• To facilitate proper crediting, ensure your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.
• The Department of Human Services will conduct reference checks to verify job-related credentials and a criminal background check prior to appointment.

Pay

$26.89 - $39.22 / hourly; $56,146 - $81,891 / annually

Schedule

• Work Shift/Work Hours: Day Shift / Varies
• Days of Work: Monday - Friday
• Telework Eligible: Yes (applicants who reside in Minnesota or in a bordering state, within 50 miles or less from the primary work location)
• Travel Required: No
• Full/Part Time: Full-Time
• Regular/Temporary: Unlimited

Benefits

As an employee, you'll have access to one of the most affordable health insurance plans in Minnesota, along with other benefits to help you and your family be well. Your benefits may include:

• Paid vacation and sick leave
• 12 paid holidays each year
• Low-cost medical, dental, vision, and prescription drug plans
• Fertility care, including IVF
• Diabetes care
• Dental and orthodontic care for adults and children
• 6 weeks paid leave for parents of newborn or newly adopted children
• Pension plan that provides income when you retire (after working at least three years)
• Employer paid life insurance to provide support for your family in the event of death
• Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
• Tax-free expense accounts for health, dental, and dependent care
• Resources that provide support and promote physical, emotional, social, and financial well-being
• Support to help you reach your career goals:
  • Training, classes, and professional development
  • Tuition reimbursement
  • Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov)
• Employee Assistance Program (EAP) for work/life support:
  • A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance
  • Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
  • Daily Living/Convenience Services: Chore services, home repair, trip planning, child/elder care

Programs, resources and benefits eligibility varies based on type of employment, agency, funding availability, union/collective bargaining agreement, location, and length of service with the State of Minnesota.