OIG Provider Enrollment Screening Specialist

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: OIG Provider Enrollment Screening Specialist 
Job Title: Research Specialist III 
Agency: Health & Human Services Comm 
Department: Provider Enrollment HB500 
Posting Number: 7362 
Closing Date: 10/21/2025 
Posting Audience: Internal and External 
Occupational Category: Business and Financial Operations 
Salary Group: TEXAS-B-20 
Salary Range: $4,263.16 - $5,521.16 
Pay Frequency: Monthly
Shift: Day 
Additional Shift: Days (First) 
Telework: Eligible for Telework 
Travel: Up to 10% 
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: Austin; Abilene; Alamo; Alice; Alpine; Alvin; Amarillo; Anahuac; Andrews; Angleton; Anson; Aransas Pass; Archer City; Arlington; Athens; Atlanta; Bacliff; Ballinger; Bandera; Bastrop; Bay City; Baytown; Beaumont; Bedford; Beeville; Bellville; Big Spring; Boerne; Bonham; Borger; Bowie; Brady; Breckenridge; Brenham; Brownfield; Brownsville; Brownwood; Bryan; Burnet; Caldwell; Cameron; Canton; Canutillo; Carlsbad; Carrizo Springs; Carrollton; Carthage; Center; Centerville; Childress; Clarksville; Cleburne; Cleveland; Coldspring; Columbus; Conroe; Copperas Cove; Corpus Christi; Corsicana; Crockett; Crosby; Crystal City; Cuero; Cypress; Daingerfield; Dallas; Decatur; Del Rio; Denton; Dickinson; Dumas; Duncanville; Eagle Pass; Eastland; Edinburg; El Paso; Elgin; Elsa; Ennis; Fabens; Falfurrias; Floresville; Fort Stockton; Fort Worth; Fredericksburg; Gainesville; Galveston; Garland; Gatesville; Georgetown; Giddings; Gilmer; Goliad; Gonzales; Graham; Granbury; Grand Prairie; Grapevine; Greenville; Hallettsville; Hamilton; Harlingen; Haskell; Hearne; Hemphill; Hempstead; Henderson; Hereford; Hillsboro; Hondo; Houston; Humble; Huntsville; Hurst; Irving; Jacksonville; Jasper; Johnson City; Jourdanton; Karnes City; Katy; Kaufman; Kerrville; Killeen; Kingsville; Kingwood; Kirbyville; La Grange; Lake Jackson; Lake Worth; Lamesa; Lampasas; Lancaster; Laredo; Levelland; Lewisville; Liberty; Linden; Littlefield; Livingston; Llano; Lockhart; Longview; Lubbock; Lufkin; Lumberton; Madisonville; Marble Falls; Marfa; Marlin; Marshall; Mcallen; Mckinney; Mercedes; Meridian; Mesquite; Mexia; Midland; Mineola; Mineral Wells; Mission; Monahans; Mount Pleasant; Mount Vernon; Nacogdoches; Navasota; New Boston; New Braunfels; Odessa; Orange; Palestine; Pampa; Paris; Pasadena; Pearland; Pearsall; Pecos; Perryton; Pharr; Pittsburg; Plainview; Plano; Pollok; Port Arthur; Port Lavaca; Presidio; Quitman; Raymondville; Refugio; Richardson; Richmond; Rio Grande City; Robstown; Rockwall; Rosenberg; Round Rock; Rowlett; Rusk; San Angelo; San Antonio; San Benito; San Juan; San Marcos; San Saba; Schertz; Seguin; Seminole; Seymour; Sherman; Silsbee; Sinton; Snyder; Socorro; Sonora; South Houston; Stephenville; Sugar Land; Sulphur Springs; Sweetwater; Taylor; Temple; Terrell; Texarkana; Texas City; The Woodlands; Tomball; Trinity; Tyler; Uvalde; Van Horn; Vernon; Victoria; Waco; Washington; Watauga; Waxahachie; Weatherford; Webster; Weslaco; Wharton; Wichita Falls; Woodville; Zapata 
MOS Codes: 0231,0531,4505,4591,8051,8825,8850,15AX,35F,38A,49A,683X,783X,IS,ISS,OSS 
 
 
 

Job Description

OIG is a dynamic organization that specializes in the prevention, detection, audit, inspection, review, and investigation of fraud, waste, and abuse in the provision and delivery of all state health and human services and enforce state law related to the provision of those services. The Provider Enrollment Integrity Screenings (PEIS) team protects the integrity of the Medicaid System by ensuring the prevention of fraud, waste, and abuse. If you have a dedication to integrity and you want to make a difference, this may be the opportunity for you. The OIG Provider Enrollment Screening Specialist (Research Specialist III) reports to the Manager of the PEIS team in the Data Reviews division of the Office of Inspector General, performing complex (journey-level) research work within a team environment. The OIG Provider Enrollment Screening Specialist conducts reviews of provider enrollment applications into Medicaid, CHIP, and other state healthcare programs. Conducts state and federally required program integrity screenings (including criminal background checks) for providers seeking to enroll, re-enroll, or revalidate in Medicaid, CHIP, and other state healthcare programs. This position makes enrollment recommendations based on screening results, is responsible for managing their own workload and ensures enrollment recommendations are made within 10 business days, as defined by statute. Escalates information to PEIS leadership for assistance when unclear information is identified. May train others, including coordinating, planning, developing, and monitoring research assignments. May assist with the development and review of policies, procedures, and trainings, and provides feedback regarding PEIS activities. May assist with technical development and testing for systems used to research and complete the review of provider enrollment applications and screenings. Works under limited supervision, with moderate latitude for the use of initiative and independent judgment. Performs related work as assigned.  

Essential Job Functions

Reviews provider enrollment applications and completes required state and federal screening activities in order to make Medicaid, CHIP, and other state healthcare programs provider enrollment recommendations. Ensures enrollment recommendations are accurate and consistent, based on a thorough review of the information included in the application. (40%).

Manages workload and ensures recommendations are entered within 10 business days of receipt of a complete application. (30%)

Effectively communicates research, data, and analysis results, both verbally and in writing in a professional manner. (10%)

Assists PEIS leadership with in-depth research of complex situations, escalating findings or concerns as appropriate; may collect, compile; identify training needs; provides consultation and technical assistance for other research specialists in the division. (10%)

Occasional assignment of special projects. (10%) 

Registrations, Licensure Requirements or Certifications

N/A

Knowledge Skills Abilities 

•Knowledge of Texas Medicaid, CHIP, other state healthcare, and Medicare programs.
•Knowledge of federal and state laws and rules related to Texas Medicaid, CHIP, and other state healthcare programs related to provider enrollment program integrity requirements.
•Skilled at conducting research, using a variety of databases and available resources to obtain solid conclusions.
•Skilled in creative problem solving, including accessing needed resources from multiple areas and sources and helping management develop solutions.
•Skilled in customer service, team-building, and collaboration.
•Skilled in effective and professional written and verbal communication.
•Skill in searching databases and analyzing results.
•Skill using software such as Excel, PowerPoint, Access, MSWord.
•Skilled in taking initiative and working independently to meet deadlines.
•Ability to demonstrate flexibility in a changing environment.
•Ability to establish and maintain effective working relationships, set priorities, and manage time efficiently.
•Ability to prepare reports and clearly document policies and procedures.
•Ability to exercise good judgment, efficiently organize information, and effectively solve problems.
•Ability to use and learn software specific to the provider enrollment process.  

Initial Screening Criteria

Experience with Medicaid, CHIP or other state healthcare programs. Experience in completing licensing verifications with licensing boards and criminal background checks through the Department of Public Safety (DPS) or Accurint, preferred. Experience reviewing applications associated with participation in Medicaid, CHIP, and other state healthcare programs. Experience interpreting and explaining complex programs policies, procedures, rules, regulations, or guidelines preferred.  

Additional Information

The OIG is responsible for preventing, detecting, auditing, inspecting, reviewing, and investigating fraud, waste, and abuse in the provision of HHS in Medicaid and other HHS programs. Potential employees of OIG are subject to criminal background checks in accordance with the HHS Human Resources policy. Selected applicants must complete a national fingerprint-based criminal background check through the Texas Department of Public Safety (TDPS) and Federal Bureau of Investigations (FBI) to determine if they have criminal history record information that constitutes a bar to employment.

OIG will request that all applicants considered for an interview provide responses to essay questions. Failure to respond to the request could disqualify an applicant from the interview process.

Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual.

HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work. 

In compliance with the Americans with Disabilities Act (ADA), HHS 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.

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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.