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TX-HHSC-DSHS-DFPS
Reimbursement Officer I
Career Insights for Eligibility Specialist
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$46,315 / year median in Texas
+19% projected growth
Job Description
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. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Functional Title:
Reimbursement Officer IJob Title:
Reimbursement Officer IAgency:
Health & Human Services CommDepartment:
ReimbursementPosting Number:
20281Closing Date:
09/04/2026Posting Audience:
Internal and ExternalOccupational Category:
Business and Financial OperationsSalary Range:
$2,820.00 - $4,149.83Pay Frequency:
MonthlySalary Group:
TEXAS-B-12
Shift:
DayAdditional Shift:
Days (First)Telework:
Not Eligible for TeleworkTravel:
Regular/Temporary:
RegularFull Time/Part Time:
Full timeFLSA Exempt/Non-Exempt:
NonexemptFacility Location:
San Antonio State Supported Living CenterJob Location City:
SAN ANTONIO
Job Location Address:
6711 SNEW BRAUNFELS AVE
Other Locations:
MOS Codes:
No military equivalentBrief Job Description:
Come work in an environment where we truly value and respect those we serve and believe in the mission that all people can achieve a higher level of wellness and independence. The state supported living centers serve people with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. The centers provide campus-based direct services and supports at 13 centers located throughout the state. Learn About Our State Supported Living Centers If you are looking for a place to work where you can establish a career that is filled with purpose, this is the job for you! The Reimbursement Officer performs routine reimbursement or claims processing work. Maintains files on each Medicare covered individual and gathers all rendered reimbursable services from the individual's charts for purpose of billing. Maintains a working master list containing Medicare information on each individual covered by Medicare and participates in Medicare Audits. Performs various activities necessary to collect Medicare under the Intermediate Care Facilities for individuals with Intellectual Disability (ICF/ID) program. Completes and submits applications and forms in a timely manner to enroll each physician in the ICF/ID Medicare program. Responsible for enrolling each eligible individual into a Medicare Part D plan. Performs regular office functions including file maintenance, answering telephones, greeting visitors and computer entry daily. Essential Job Functions (EJFs): Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned. Gathers all rendered, reimbursable services for individuals with Medicare on a monthly basis. Meets with facility. physicians to ensure the codes used are the most accurate for rendered services Prepares a Monthly Charge Report for individuals with Medicare, using information pulled from IRIS and Individuals' medical charts. Reviews the information for accuracy and makes corrections as necessary using a current Medicare Fee Schedule. Enrolls eligible individuals into a Medicare Part D Drug Program that best fits the individuals' needs, and enters the information in the online CARE System. Establishes and maintains records on a daily basis, including documents, correspondence, forms, and lists for each individual with Medicare on campus, as well as maintains an Excel list with Medicare information updates as necessary. Prepares Medicare enrollment or revalidation forms for physicians who are employed or contracted by the facility. Assists in Medicare audits, and other related work, as required. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. Knowledge, Skills and Abilities (KSAs): Knowledge of the principles of collection and accounting, and of the rules and regulations governing reimbursement for agency services. Knowledge of the workings of Medicare Part A, Part B and Part D, as well as ICD-10-CM, CPT and HCPCS codes used when gathering monthly billing information. Skill in use of Electronic Health Records (IRIS), general office equipment, and in the operation of computers and applicable computer software. Ability to communicate effectively.Registrations, Licensure Requirements or Certifications:
None Initial Screening Criteria:
Graduation from a standard senior high school or equivalent. Experience in claims processing, health-related account and collection work, and Medicare enrollment. Experience with preparing and billing medical claims with Private, Managed Care or Government insurance agencies is preferred.Additional Information:
Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide and Employee Misconduct and HHS List of Excluded Individuals/Entities (LEIE). Males between the ages of 18 - 25 must be registered with the Selective Service. All State Supported Living Center Employees are subject to Random Drug Testing. Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours. Must be willing to work weekends and holidays. All applicants must be at least 18 years of age to be considered for employment at a state-operated facility.Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.