Reimbursement Officer I

Location: Terrell, TX

About the role

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. This role performs routine reimbursement or claims processing work, maintaining files on each covered individual and gathering all rendered reimbursable services from the individual’s charts for billing purposes. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.

HHSC is dedicated to building an atmosphere where employees feel valued and supported while providing specialized care for Texans in need. HHSC operates ten psychiatric hospitals, two youth residential treatment facilities, and thirteen state-supported living centers. Psychiatric hospitals are accredited by The Joint Commission and provide state-of-the-art, recovery-oriented, science-based treatment.

Other duties include actively participating in disaster response, recovery, or Continuity of Operations (COOP) activation, which may require alternate shift patterns or locations.

Responsibilities

• Gathers all rendered, reimbursable services for individuals with Medicare or other third-party payors on a monthly basis.
• Meets with hospital physicians to ensure the most accurate codes are used for rendered services.
• Prepares a Monthly Charge Report for individuals with Medicare or other third-party payors using information from AVATAR and medical records, reviewing for accuracy and making corrections as needed.
• Enrolls eligible individuals into a Medicare Part D Drug Program that best fits the patient’s needs and enters the information in the online CARE System.
• Establishes and maintains daily records, including documents, correspondence, forms, and lists for each patient with Medicare or other third-party payors, updating an Excel list as necessary.
• Prepares Medicare enrollment or revalidation forms for physicians employed or contracted by the hospital.
• Assists in Medicare or other third-party payor audits and related work as required.
• Attends work regularly and may be required to work specific shift schedules, extended shifts, or overtime in accordance with agency leave policy.

Requirements

• Two years’ experience in claims processing and health-related account and collection work.
• Knowledge of the principles of collection and accounting.
• Knowledge of the rules and regulations governing reimbursement for agency services.
• Knowledge of Medicare Part A, Part B, and Part D, as well as ICD-10-CM, CPT, and HCPCS codes used in monthly billing.
• Skills in using Electronic Health Records and general office equipment.
• Skills in operating computers and applicable software.
• Ability to communicate effectively.
• Must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks (CANRS, Nurse Aid, Medication Aide, Employee Misconduct, LEIE).
• Males aged 18-25 must be registered with the Selective Service.
• Must be at least 18 years of age (21 for Waco and Terrell Center for Youth applicants).
• Flexibility in work hours may be required, including overtime or extended hours.
• Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required. Non-immunized employees may need to wear protective masks.

Benefits

HHSC offers a comprehensive benefits package, including:

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

Explore more details on the Benefits of Working at HHS webpage.

Pay

Salary range: $2,820.00 - $4,149.83 per month.

Schedule

• Full-time, regular position.
• Shift: Day (First shift).
• Travel: Up to 10%.
• Telework: Not eligible.