Special Projects Specialist - PB

Schedule:

Main Function:

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.

Job Specific Competencies:

• Project Coordination: Plan, organize, and oversees special projects, ensuring deliverables are met.
• Professional Billing Expertise: In-depth knowledge of professional billing processes, CPT/HCPCS coding, modifier usage, and payer reimbursement methodologies.
• EPIC EMR Proficiency: 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.
• Analytical & Problem-Solving: Exceptional ability to analyze complex financial data, identify discrepancies, and develop effective solutions.
• Regulatory & Payer Compliance: Strong understanding and adherence to federal, state, and local regulations, including Medicare, Medicaid, and commercial payer guidelines specific to professional billing.
• Communication Skills: 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.
• Attention to Detail: Meticulous accuracy in reviewing accounts and documenting actions.
• Organizational & Time Management: Ability to manage a high volume of diverse accounts and prioritize tasks effectively across multiple entities.
• Process Improvement Orientation: Proactive in identifying trends and suggesting enhancements to professional billing workflows.
• Training & Support: Act as a subject matter expert, providing guidance and support to billing staff on complex cases or new processes introduced through special projects.
• Patient Communication: Handle escalated patient inquiries regarding complex billing issues with empathy and clarity, ensuring a positive patient experience.

Qualifications:

• Multi-System Experience: Proven ability to manage billing and credit processes for multiple health systems simultaneously is highly preferred.
• Knowledge: In-depth understanding of hospital revenue cycle operations, medical billing terminology, CPT/ICD-10 coding, and payer reimbursement methodologies (Medicare, Medicaid, commercial insurance).
• Skills:
• 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.

Education and Experience:

• Required: High school diploma or equivalent.
• Preferred: Associates or Bachelors degree in Business Administration, Finance, Healthcare Administration, or a related field.
• Required: Minimum of 5 years of dedicated experience in professional billing, with a strong emphasis on problem resolution and resolving complex billing related issues.
• Required: Demonstrated experience working with EPIC EMR for professional billing.
• Highly Preferred: Experience managing professional billing for multiple health systems, specialties, or a high volume of practices.

Pay Range: $20.00 - $24.00 per hour

Starting Pay: Based on experience

Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply