Special Projects Manager

ENT and Allergy Associates•Tarrytown, GA

1d•$75,000 - $80,000•Onsite

About The Position

ENT and Allergy Associates, LLP and Hümi are seeking a self-motivated, people-friendly full time Special Projects Manager for our Corporate office location located in Tarrytown, NY. Salary - $75,000 - $80,000 We are seeking a highly detail‑oriented and analytical Special Projects Manager to support key Revenue Cycle operations. This individual contributor role is responsible for managing fee schedules, maintaining payer data, supporting contract accuracy, troubleshooting insurance issues, and partnering with multiple internal teams to ensure clean claims, accurate reimbursement, and optimized system functionality. This role requires strong problem‑solving skills, deep understanding of insurance billing workflows, and the ability to independently manage complex projects from start to finish. Experience working in Epic or a similar EHR/PM system is required.

Requirements

Epic experience preferred.
3–5+ years of experience in Revenue Cycle, billing, or payer operations.
Strong understanding of contracts, fee schedules, and payer rules.
Excellent analytical skills with the ability to interpret reimbursement trends.
Ability to manage multiple priorities and work independently in a fast‑paced environment.
Strong communication skills and ability to collaborate across departments.
High proficiency with spreadsheets, reporting, and system navigation.

Responsibilities

Fee Schedules, Contracts & Rates Review new and existing payer contracts for fee schedule rates, time limits, participation details, and line‑of‑business requirements.
Build, update, and audit fee schedules based on contract terms, Medicare annual updates, quarterly rate changes, and new CPT/HCPCS codes.
Ensure fee schedules populate correctly across the system; resolve discrepancies related to file maintenance, provider participation, or regional assignments.
Conduct periodic contractual rate audits (every 60–90 days) to verify correct claim adjudication for top-volume codes.
Upload revised fee schedules into the contract utility after-hours as required.
Manage and update organizational “Golden Rules,” summarizing key payer policies for the Revenue Cycle team.
Review collector-submitted policies, identify applicable updates, and ensure rules remain accurate based on insurer notifications.
Maintain and continuously update the payer plan crosswalk to ensure accurate patient registration and downstream billing.
Research payer plan changes through carrier representatives, internal rosters, and online resources.
Communicate all updates to relevant teams (PSA, PRRC, Revenue Cycle, HIT, Business Development).
Partner with Business Development to ensure new plans are incorporated into the Insurance Grid.
Act as a primary point of contact for resolving payer-specific contractual issues.
Attend revenue cycle meetings with insurance carriers; maintain issue-tracking documentation.
Collaborate with collectors and PSAs to investigate issues and work with insurance reps until claims are corrected and resolved.
Maintain system files, libraries, and lists within File Maintenance to ensure accurate backend configuration (provider participation, payers, contracts, reason codes, CPT codes, transaction codes).
Assist with adding or updating provider participation and creating new payers due to contract or billing changes.
Conduct annual charge master reviews to ensure organizational charge amounts exceed allowable reimbursement rates.
Update rates as needed, review future contract rates, and secure leadership approval prior to implementation.
Provide daily support to collectors, PSAs, and cross-functional departments regarding participation questions, claims issues, and contract clarification.
Partner closely with APP Development, Business Development, and Credentialing to address payer configuration issues and maintain accurate records.
Analyze A/R and adjustment reports to identify denial or reimbursement trends.
Investigate root causes and collaborate with Billing, payers, or collectors on solutions, rule changes, or policy updates.
Review and approve refunds prior to processing by the Refund Department.
Maintain and update NY Medicaid ePaces provider information.
Add new team members and ensure data accuracy.
Review RevSpring statement and postcard billing invoices for accuracy.
Coordinate with Accounting and track counts via BBP and email reporting.
Participate in testing for all NextGen upgrades to ensure Revenue Cycle functionality performs as expected.
Move money/reconcile as needed (typically monthly near close).
Review ENTA’s unclaimed funds annually.