Special Projects Specialist - PB
About The Position
The Special Projects Specialist serves as a key point of contact for cross-functional initiatives, ensuring seamless communication and coordination between departments. This role is responsible for managing special projects from conception to completion, aligning objectives with organizational goals, and delivering results within established timelines. This role involves meticulous research and understanding of the entire revenue cycle encompassing multiple specialties across five health systems. The Special Projects Patient Account Specialist must have the ability to identify opportunities for operational efficiency and recommend solutions to enhance project outcome. This role involves advanced ability to navigate, utilize and trouble shoot the EPIC EMR for patient accounting, claim status, payment review, and documentation. This role plays a vital part in maintaining the financial integrity of our professional operations, ensuring compliance with all regulatory requirements and internal policies.
Requirements
- High school diploma or equivalent.
- Minimum of 5 years of dedicated experience in professional billing, with a strong emphasis on problem resolution and resolving complex billing related issues.
- Demonstrated experience working with EPIC EMR for professional billing.
- Proven ability to manage billing and credit processes for multiple health systems simultaneously is highly preferred.
- In-depth understanding of hospital revenue cycle operations, medical billing terminology, CPT/ICD-10 coding, and payer reimbursement methodologies (Medicare, Medicaid, commercial insurance).
- Exceptional analytical and problem-solving abilities.
- Strong attention to detail and accuracy.
- Excellent verbal and written communication skills.
- Proficiency in using patient accounting systems (e.g., Epic, Cerner, Meditech) and Microsoft Office Suite (Excel, Word).
- Ability to work independently and as part of a team in a fast-paced, high-volume environment.
- Strong organizational and time management skills.
Nice To Haves
- Associate's or Bachelor's degree in Business Administration, Finance, Healthcare Administration, or a related field.
- Experience managing professional billing for multiple health systems, specialties, or a high volume of practices.
Responsibilities
- Plan, organize, and oversee special projects, ensuring deliverables are met.
- In-depth knowledge of professional billing processes, CPT/HCPCS coding, modifier usage, and payer reimbursement methodologies.
- Advanced ability to navigate and utilize EPIC EMR for patient accounting, claim status, payment review, and documentation. Ability to work with ISD to identify EPIC related issues and opportunities which may involve testing.
- Exceptional ability to analyze complex financial data, identify discrepancies, and develop effective solutions.
- Strong understanding and adherence to federal, state, and local regulations, including Medicare, Medicaid, and commercial payer guidelines specific to professional billing.
- Excellent verbal and written communication for interacting with patients, payers, and internal teams. Acts as primary liaison between internal teams, leadership and external partners to facilitate collaboration and resolve issues.
- Meticulous accuracy in reviewing accounts and documenting actions.
- Ability to manage a high volume of diverse accounts and prioritize tasks effectively across multiple entities.
- Proactive in identifying trends and suggesting enhancements to professional billing workflows.
- Act as a subject matter expert, providing guidance and support to billing staff on complex cases or new processes introduced through special projects.
- Handle escalated patient inquiries regarding complex billing issues with empathy and clarity, ensuring a positive patient experience.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
