Reimbursement Analyst V

Date: Aug 6, 2026 Location: AUSTIN, TX 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. Functional Title: Reimbursement Analyst V Job Title: Reimbursement Analyst V Agency: Health & Human Services Comm Department: HHSC & HHS Rate Analysis M/C Posting Number: 19757 Closing Date: 08/20/2026 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 Travel: Up to 10% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Telework: Job Location City: AUSTIN Job Location Address: 4601 W GUADALUPE ST MOS Codes: No military equivalent 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 V position performs highly advanced (senior-level) consultative services, oversight, policy and data development, and technical analyses work for the Provider Finance Department under the supervision of the SHARS/MAC/TS Manager within Acute Care. This position provides technical guidance and performs work in the administration of School Health and Related Services (SHARS), Medicaid Administrative Claiming (MAC), and Random Moment Time Study (RMTS) programs. Duties are performed under limited supervision, with considerable latitude for the use of initiative and independent judgment. This position will act as a team lead and will function as a backup to their supervisor for program matters and this position. Essential Job Functions (EJFs) Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned (35%) Develops, modifies, and maintains complex data analysis and statewide time study results used in cost reimbursement and to determine payment rates. (35%) 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 financial methodology issues affecting program participation, delivery, and payment determination. (20%) Reviews quarterly and annual cost reports and issues official settlement and reimbursement decisions (15%) Develops and processes policy documents (including policy guidelines, agency rules, state plan amendments, council and advisory committee items, workgroup materials,) relating payment rate and payment methodology determination. Documents work processes and escalates issues as needed. (10%) Works with providers and HHSC legal on informal and formal appeals resulting from cost report disallowances. This includes extensive research and the ability to testify in court upon request from the HHSC legal department. (10%) Develops and conducts on-line and/or classroom based educational training programs related to the completion of data collection instruments. (5%) Performs other work as assigned or required to maintain and support the office and HHSC operations (5%) Knowledge, Skills And Abilities (KSAs) 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. Knowledge of claims processing and/or cost report review and completion. Knowledge of Texas SHARS, MAC, RMTS, or other related programs. Skill in the development, implementation, and application of reimbursement methodologies and payment rates. 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 Skill in mathematical calculations and use of associated software to calculate 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 to develop payment rates. Ability to exercise independent judgement, 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 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. Ability to train others on policies and procedures related to job functions. Registrations, Licensure Requirements Or Certifications N/A Initial Screening Criteria Graduation from an accredited four-year college or university with a bachelor’s degree in social science; business, including accounting and statistics; economics; health-related field; political science; or other closely related field. Experience may be substituted on a year for year basis. Experience of Medicaid and/or healthcare finance preferred. Experience with Salesforce software preferred. 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 View phone number on click.appcast.io. 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. Nearest Major Market: Austin #J-18808-Ljbffr Texas Health and Human Services