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About the Role

The Texas Health and Human Services Commission (HHSC) Medicaid & CHIP Services (MCS) department seeks a qualified candidate for a Customer Service Representative in the Provider Claims Services (PCS) unit. This position performs advanced customer service work in a call center environment, handling inquiries from Medicaid Long Term Care (LTC) providers, recipients, and staff regarding claims and billing issues.

Responsibilities

Responds to inquiries regarding claims processing and billing issues for Medicaid LTC providers, recipients, agency case workers and eligibility staff via emails, reports, correspondence, or hotline.
Researches and analyzes data within various automated systems to identify issues with claim processing/billing.
Documents information in spreadsheets.
Enters data, supporting records and actions taken to resolve billing or claims processing issues.
Uses multiple systems including Client Assignment and Registration System (CARE), IDD Portal, Service Authorization System Online (SASO), Texas Medicaid and Health Care Partnership (TMHP) Long Term Care Portal, and a call tracking system.
Provides training to Medicaid providers on how to address or resolve issues in filing/processing claims.
Interprets section policies and procedures for processing claims and service authorizations for LTC providers.
Collaborates with PCS coaches to resolve more complex claims/billing issues or provider concerns.

Requirements

Two years' experience working in a call center or customer service-oriented environment.
Preferred experience with Provider Claims Services systems.
Preferred experience in researching and interpreting Medicaid policies and procedures.

Skills

Skill in the use of standard office equipment.
Skill and experience resolving complicated billing issues promptly and efficiently.
Experience utilizing Microsoft Office Excel spreadsheets.
Ability to apply policies and procedures and recommend changes.
Ability to review problems and recommend solutions.
Ability to communicate verbally with stake holders.

Location

AUSTIN

Work Type

Full time
Telework may be available

Experience Level

Advanced

Education Level

None required

Salary/Compensations

$3,581.33 - $4,476.91 Monthly

Benefits

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

About the Company

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.

Equal Opportunity

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability.
Active Duty, Military, Reservists, Guardsmen, and Veterans: Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position.