Remote Healthcare Payment Validation Specialist

Mosaic Life Care; Central City (KY); Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Concierge services

Employee lounge

Wellness programs

Free parking (on-site)

Job summary

Mosaic Life Care is hiring a Payment Validation Analyst to ensure accurate payer payments and optimize revenue integrity. This role focuses on reviewing encounters in Epic WQs, correcting contract and CPT-related issues, and leading underpayment recoupment efforts.

The analyst will act as a subject matter expert on payer reimbursements, coordinate with the Revenue Integrity team, and support start-up processes for new programs while ensuring compliance and accuracy across billing operations.

Qualifications

• Bachelor's Degree is required.
• 5+ years of healthcare finance experience including reimbursement, coding, and charge audits.
• In-depth knowledge of CPT/HCPCS/ICD-10 and Medicare reimbursement.
• Experience with Epic preferred.

Responsibilities

• Analyze contractual underpayments and resolve daily encounters in Epic WQs.
• Identify root causes and implement corrective actions.
• Resolve price/contract discrepancies and coordinate fee schedule corrections.
• Lead rebill projects for underpayments and recoupment.
• Research non-covered/denied charges and assist with appeals.
• Educate staff on identified coding/billing issues and monitor re-billings.

Skills

Data entry

Communication

Analytical thinking

Numbers & analytics

Attention to detail

Confidentiality

Team collaboration

Education

Bachelor's degree - Required

High School Diploma - Required

5+ years healthcare finance experience

CPT/HCPCS/ICD-10 knowledge

Job description

Mosaic Life Care is hiring a Payment Validation Analyst to ensure accurate payer payments and optimize revenue integrity. This role focuses on reviewing encounters in Epic WQs, correcting contract and CPT-related issues, and leading underpayment recoupment efforts.

The analyst will act as a subject matter expert on payer reimbursements, coordinate with the Revenue Integrity team, and support start-up processes for new programs while ensuring compliance and accuracy across billing operations.