Reimbursement analyst v

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Functional Title: Reimbursement Analyst V Job Title: Reimbursement Analyst V Agency: Health & Human Services Comm Department: HHSC & HHS Rate Analysis LTC Posting Number: 20470 Closing Date: 10/24/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Range: $5,797.66 - $9,508.25 Pay Frequency: Monthly Salary Group: TEXAS-B-25 Shift: Day Additional Shift: Telework: Eligible for Telework Travel: Up to 5% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location: Job Location City: AUSTIN Job Location Address: 4601 W GUADALUPE ST Other Locations: MOS Codes: No military equivalent

Brief Job Description: The Reimbursement Analyst V position processes Medicaid and Non-Medicaid cost reports under the supervision of the Manager of the Cost Report Team within the Long-Term Services and Supports (LTSS) section of the Texas Health and Human Services Commission (HHSC) Provider Finance Department (PFD).

The position entails highly advanced (senior-level) technical work in the development and processing of provider cost reports or financial compliance reports for Medicaid and other programs, including calculating reconciliations of cost reports for direct care and patient care expense ratios; processing informal review requests and conducting financial reviews; developing new processes and process improvements; and maintaining cost report instructions, worksheets, and policies and procedure documentation.

This position works under minimal supervision with extensive latitude for the use of initiative, prioritizing assigned tasks, and independent judgment.

ESSENTIAL JOB FUNCTIONS (EJF):

• Leadership & Oversight (25%): Conducts peer reviews and acts as a resource for junior staff in the completion of informal reviews and reconciliations. Coordinates among teammates to analyze processes and develop process improvements.
• Stakeholder and Staff Communication (25%): Communicates complex information to internal and external parties to provide, exchange, or verify information; answer inquiries; address issues; or resolve problems or complaints. Interfaces with various contracted providers, provider representatives, client advocates, other agency staff, advisory committees, workgroups, attorneys, and other interested parties concerning payment rate policy issues affecting LTSS cost reporting. Participates in public meetings and records and summarizes public testimony regarding PFD initiatives.
• Cost Report Development (25%): Works with senior-level teammates to conduct cost report reviews and improvements. Updates cost reports as program and reporting requirements change. Develops new cost reports to meet data collection and reporting requirements for LTSS programs.
• Cost Report Instructions and Policy Documentation (10%): Drafts instruction documentation for LTSS cost and financial compliance reports. Ensures documentation details how providers should use HHSC’s electronic cost reporting system to complete their cost or financial compliance report. Ensures documentation meets accessibility and plain language requirements and HHSC established communication guidelines. Drafts policy documents for external or internal audiences relating to LTSS cost reporting to ensure compliance with established procedures, requirements, laws, and regulations.
• Cost and Financial Compliance Report Informal Reviews (5%): Conducts informal reviews on LTSS cost and financial compliance reports by evaluating the informal review request submitted by the provider and reconciling supporting financial documentation with the adjustments made during HHSC PFD Financial Examination. Ensures informal review adjustments are allowable and processed timely in accordance with Texas Administrative Code rules, program guidelines, and established processes and procedures. Coordinates with the Cost Report Review Unit regarding the results of the informal review. Communicates results of the informal review with stakeholders, including by representing the department in formal appeal hearings.
• Cost Report and Financial Compliance Report Reconciliation (5%): Conducts cost and financial compliance report reconciliations necessary to hold providers accountable to State and Federal requirements across programs and initiatives. Communicates results to providers. Maintains applicable reporting deadlines. Ensures cost and financial compliance reports are processed according to established policies and procedures and Texas Administrative Code rules.
• Other Duties as Assigned (5%): Performs other work as assigned required to maintain and support the office and HHSC operations.

Total: 100%

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED: None Required.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

Knowledge of:

• LTSS cost reporting and financial examination practices.
• The Texas Legislative process.
• Microsoft Word at an advanced level and the use of HHS accessible templates. (Use of Styles to format documents, Table Styles, HHS Reports tab to create and format reports, page and section breaks to format long documents with different page styles, embedding documents, and able to create accessible documents).
• Microsoft Excel at the intermediate level. (Set up footers, headers, align margins, sort and filter, conditional formatting, insert links, concatenation, able to convert to accessible Adobe Acrobat format).

Skill in:

• Strong analytical skills with the ability to collect, analyze, organize, and communicate significant amounts of complex information with attention to detail, accuracy, professionalism, and diplomacy.
• Strong critical thinking skills with the ability to evaluate and implement effective alternative solutions.
• Interpersonal relationships, teamwork, and establishing and maintaining effective working relationships with people at various levels of expertise.
• Communicating clearly and concisely, both verbally and in writing with attention to detail.
• Use of Microsoft Office Suite products (MS Word, Excel, PowerPoint, Outlook, SharePoint, Visio, and others).

Ability to:

• Perform and interpret numerical analyses to analyze, evaluate, and summarize financial and management records for accuracy and conformance to procedures, rules, and regulations.
• Collaborate and work well with others with professionalism and diplomacy.
• Exercise initiative, discretion, and good judgment.
• Work under limited supervision, exercise independent judgment, set priorities, meet deadlines and adapt to shifting technical and work environmental developments.
• Manage projects effectively and produce quality work within expected deadlines.
• Maintain accurate, detailed, and organized documentation of assignments and projects.

INITIAL SCREENING CRITERIA:

Graduation from a four-year college or university with major coursework in accounting, business administration, finance, economics, statistics, or a related field is required. Experience in Provider Finance or an applicable organization may be substituted for education on a one-to-one basis. Minimum of 3 years of experience in financial examinations, financial analysis, technical writing, Medicaid reimbursement, cost reporting experience, or providing technical guidance is required. Experience in developing, compiling, analyzing, and interpreting statistical data for reimbursement analysis, preferred. Experience in working with MS Excel and MS Word, preferred.

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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. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations: 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. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility: Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer: This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.