Reimbursement Analyst I

Brief Job Description:

This position is hybrid with (currently) two in-office days per week in Austin. Applicants from outside Texas must be willing to relocate within 30 days of hire.

The Reimbursement Analyst I (RAI) reports to the Manager of Acute Care Services Payment Comparison and serves as an entry-level analyst on the Acute Care Services Payment Comparison team. This team is responsible for supporting the design, development, and compliance of federal payment rate requirements and reporting.

The RAI assists with maintaining applications, spreadsheets, and databases used in payment rate determinations and reporting activities. The position supports data collection, validation, analysis, documentation, and reporting efforts to ensure compliance with state and federal requirements. The RAI prepares written materials, participates in meetings, responds to routine inquiries, and assists with special projects related to reimbursement and payment policy activities.

The RAI works collaboratively with team members to support operational activities, maintain documentation, and contribute to program improvement initiatives. Work is performed under moderate supervision with opportunities to exercise initiative and develop independent judgment.

Essential Job Functions (EJFs):

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

Drafting, Review, and Reporting (35%)

• Assists with the preparation, review, and maintenance of reports, analyses, and other deliverables. Supports the analysis of payment rates, claims data, and financial information. Reviews state and federal regulations to understand program requirements and assists in documenting findings. Drafts routine correspondence, reports, and supporting documentation for review by senior staff. Assists in ensuring assigned deliverables are completed accurately and on schedule.

Coordination and Communication (20%)

• Communicates with Provider Finance staff, providers, HHS Enterprise staff, contractors, and other stakeholders regarding payment rate and reporting activities. Responds to routine inquiries and requests for information. Participates in workgroups and meetings and provides analytical support as needed. Collaborates with team members to resolve issues and improve processes.

Workflow Management (20%)

• Maintains assigned workloads and project activities to support timely completion of reports, notices, submissions, and other required deliverables. Tracks assignments and deadlines, identifies potential issues, and communicates concerns to management. Assists with gathering information for legislative requests, fiscal analyses, and other program activities as assigned.

Processes and Procedures (20%)

• Assists with developing, documenting, and maintaining process and procedure documentation. Follows established procedures to promote consistency, quality, knowledge retention, and operational efficiency. Identifies opportunities for process improvements and communicates recommendations to management.

Other Duties (5%)

• Performs other work as assigned or required to support the office and HHSC operations.

Knowledge, Skills and Abilities (KSAs):

Knowledge of:

• Advanced Microsoft Office (Excel, Word, etc.), business objects, TMHP Software, claims processing engines, and Salesforce.
• Data analysis, statistics, data visualization, medical claims data, methods of funding, program rules, Medicare, and Medicaid.
• Business administrative processes.
• Database and spreadsheet applications.
• Data quality and integrity processes.
• Process improvement or quality assurance systems.

Skill in:

• Managing multiple assignments and priorities.
• Organizing and analyzing data.
• Problem solving and attention to detail.
• Working collaboratively and cooperatively with diverse groups.
• Written and verbal communication.

Ability to:

• Learn reimbursement methodologies and payment systems.
• Interpret and apply policies, procedures, and regulations.
• Organize and present information effectively, both orally and in writing to technical and non-technical audiences.
• Establish and maintain effective working relationships.
• Meet deadlines and adapt to changing priorities.
• Prepare reports and summarize findings.