HCBS-AMH Billing Specialist

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Functional Title: HCBS-AMH Billing Specialist
Job Title: Program Specialist V
Agency: Health & Human Services Comm
Department: BH Waivers-HCBS-AMH
Posting Number: 20436
Closing Date: 09/23/2026
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Range: $4,523.16- $7,253.83
Pay Frequency: Monthly
Salary Group: TEXAS-B-21
Shift: Day
Additional Shift: Days (First)
Telework:
Travel: Up to 15%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location:
Job Location City: AUSTIN
Job Location Address: 4601 W GUADALUPE ST
Other Locations:
MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS

Brief Job Description:

The Texas Health and Human Services Commission (HHSC) Behavioral Health Medicaid Programs (BHMP) unit seeks a highly qualified
candidate to fill the Home and Community-Based Services - Adult Mental Health (HCBS-AMH) Billing Specialist, or Program Specialist V,
position. BHMP is driven by the program mission and vision to deliver quality, cost effective services to Texans. The Program Specialist V
works under the general direction of the HCBS-AMH Manager or the designee with considerable latitude for use of initiative and
independent judgment. Specialist functions as part of a team specifically designated to work on oversight and management of the
Medicaid State Plan Amendment, 1915(i) program, called Home and Community-Based Services - Adult Mental Health (HCBS-AMH) for
persons with serious mental illness. The HCBS-AMH program provides an array of services appropriate to each person's needs to enable
them to live and experience a successful tenure in their community. Services are designed to support long-term recovery from mental
illness and to divert placement in correctional facilities, hospital emergency departments and psychiatric hospitalization.
The Program Specialist V will perform advanced (senior-level) consultative services and technical assistance work that involves working
with community-based providers. Duties may include: processing and tracking billing functions and practice, technical assistance for
program providers, policy oversight, service delivery oversight, quality management activities, data analysis, and program evaluation
activities. Performs highly advanced professional administrative and policy analysis work. Work involves evaluating systems and
procedures, including evaluating operation and procedure manuals to assist management in operating more efficiently and effectively.

Specialist will work closely with other BHMP staff members, Texas Health and Human Services Commission (HHSC), and TMHP to develop and implement program policy initiatives, and ensure project course corrections when needed including Billing Manual updates. Works closely with the mental health providers contracted to provide state plan program services to ensure contractual language and services are in alignment with policy. Oversees policy updates and alignment of program services with proposed or actual legislative changes and requirements.

Essential Job Functions (EJFs):

Provides complex consultative services, coordination and technical assistance related to billing and contract oversight. Plan to implement, and monitor HCBS programs. Works closely with community-based providers and local mental health authorities. Monitors provider contracts. Works closely with Contract Management Unit to develop statements of work for providers. (25%)

Develops and updates program policies and procedures related to implementation and monitoring of HCBS-AMH program services. Develops and updates program billing guidelines. Ensures that community based providers receive training on new policies procedures and guidelines and conducts periodic monitoring to ensure compliance. (15%)

Assists with HCBS-AMH participants recovery plans and clinical eligibility reviews to authorize services and verify eligibility with HCBS-AMH program requirements. (15%)

Conducts and coordinates quality and utilization desk reviews to determine compliance with HCBS program requirements, laws, regulations, policies, and procedures. Analyzes reviews of HCBS-AMH program services and develops action plans to improve effectiveness, if needed. Communicates those findings, orally and in writing, to a wide variety of audiences, including from DSHS, HHSC, and CMS. (10%)

Participates in quality monitoring program to ensure that identified problems are acted upon and resolved promptly. Works with team members to determine when course corrections are required when program or program provider is not achieving goals or objectives. (10%)

Determines trends and resolves operational problems, within HHSC and within contracted community provider organizations. These consist of service delivery issues, data collection/submission issues, data entry issues, data analysis issues, invoicing processing issues (by providers), invoice processing issues (by HHSC) . (10%)

Works closely with the Billing/Utilization Lead to develop effective and streamlined billing practices and improve methods to track and present data. (10%)

Collects, organizes, analyzes, and prepares material in response to requests for information. Synthesizes complex information for presentation to a wide variety of groups, orally and in writing. These groups consist of BHMP leadership, HHSC leadership, CMS and various stakeholders. (5%)

Knowledge, Skills and Abilities (KSAs):

· Knowledge of local, state, and federal laws related to the program area; of public administration and management techniques; of statistical analysis processes; and of program planning and implementation

· Knowledge of Texas public mental health system, and of HHSC Texas Resilience and Recovery (TRR) program.

· Knowledge of local, state and federal laws and regulations relevant to long-term care and 1915 (i) waivers.

· Knowledge of Medicaid rules and regulations.

· Skill in communication and public speaking.

· Skill in managing multiple and competing priorities

. Skill in Excel and Microsoft office products

· Skill in identifying problems, evaluating alternatives, and negotiating and implementing solutions.

· Skill in working collaboratively and cooperatively with diverse groups.

· Ability to function effectively in a fast-paced environment, to oversee/manage multiple complex projects simultaneously, and to meet deadlines.

· Ability to evaluate and interpret policies and procedures.

· Ability to exercise initiative and independent judgment

· Ability to analyze data for completeness and accuracy and to resolve issues promptly.

· Ability to interact with multiple, diverse stakeholder groups.

· Ability to maintain regular work hours.

· Ability to effectively communicate orally and in writing.

Registrations, Licensure Requirements or Certifications:

N/A

Initial Screening Criteria:

Graduation from an accredited four-year college or university with major coursework in human services, business administration, public health, public affairs, public policy or a related field is required. Advanced degree from a U.S. accredited college or university with specialization in public administration, public health, business administration, human services, or related areas, or equivalent post Master's degree training preferred.

Professional experience with Health and Human Services programs, Medicaid waivers, and/or other policy focused initiatives, projects or programs preferred. Demonstrated experience in Excel.

Additional Information:

N/A

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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 View phone number on aiapply.co. 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.