Reimbursement Analyst II

3 days ago

Austin, Texas, United States Health & Human Services Comm Full time
Job Description:

The Reimbursement Analyst II position plays a critical role in the Provider Finance Department, working under the supervision of the Manager of the Payments Team. This position requires advanced consultative services and expertise in the collection of intergovernmental transfers and administration of payments for supplemental or directed payment programs administered by PFD. The successful candidate will work with minimal supervision and have considerable latitude for the use of initiative and independent judgment to ensure the proper operation of specific payment programs.

Key Responsibilities:
  • Plan, review, develop, and implement payment processes, which may include coordinating with other teams within PFD and external stakeholders.
  • Reconcile data, design instructions/processes and procedures as needed, and conduct complex data analysis to ensure accurate collection of local funding and issuance of payments.
  • Provide technical assistance to individuals both internal and external to the agency.
  • Develop, modify, and maintain complex spreadsheets using large databases to perform payment analysis.
  • Participate in the development of policy guidelines, agency rules, state plan amendments, and other associated documents relating to payments, as directed.
  • Review policies and procedures for job duties and update documents as necessary to conform to best practices.
  • Train Reimbursement Analyst I on job duties and completion of peer reviews.
Essential Job Functions:
  • Attend work on a regular and predictable schedule in accordance with agency leave policy and perform other duties as assigned.
  • Act as senior staff for specific Medicaid supplemental and directed payment programs.
  • Coordinate closely with the Team Lead and Manager of the Payments Team to ensure program payment objectives are met in a timely and efficient manner.
  • Provide guidance and training to other analysts to develop and maintain consistency through standard procedures when processing payments.
  • Work collaboratively to collect, organize, analyze, and prepare materials in response to requests for information and reports.
Knowledge, Skills, and 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.
  • 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.
  • Ability to exercise independent judgment, 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 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 well-written briefing documents and reports designed to convey complex detailed concepts.

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