Remote Payment Integrity Analyst

Mosaic Life Care; Missouri; Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Concierge services

Employee lounge

Wellness programs

Free parking on-site

Job summary

Mosaic Life Care in Missouri seeks a Payment Validation Analyst to ensure accurate payments from payors and to perform line-level validation when needed. The role reports to the Director of Revenue Integrity and involves resolving contract underpayments, price discrepancies, and denials within Epic.

The ideal candidate has extensive hospital financial operations experience, CPT/HCPCS coding knowledge, and Epic system familiarity, with in-depth accuracy and confidentiality requirements.

Qualifications

• Bachelors degree required; healthcare experience preferred.
• Experience with hospital financial operations and revenue integrity is beneficial.
• Epic system experience or certifications are preferred.

Responsibilities

• Analyze contractual underpayments and identify root causes; resolve daily encounters in Epic WQs.
• Investigate price/contract discrepancies and work with CDM/Revenue Integrity to correct fees.
• Lead rebill projects focusing on recovering underpayments.
• Research non-covered or denied charges and assist with appeals with Revenue Integrity Manager.
• Identify coding/billing patterns causing underpayment and educate staff to resolve them.
• Prepare monthly measurement reports using Epic reports and document findings.

Skills

Analytical thinking

Attention to detail

Data entry

Communication skills

Problem solving

Education

Bachelor's degree

High School Diploma

Tools

Epic Reports

Epic Contracts Module Certification

Job description

Mosaic Life Care in Missouri seeks a Payment Validation Analyst to ensure accurate payments from payors and to perform line-level validation when needed. The role reports to the Director of Revenue Integrity and involves resolving contract underpayments, price discrepancies, and denials within Epic.

The ideal candidate has extensive hospital financial operations experience, CPT/HCPCS coding knowledge, and Epic system familiarity, with in-depth accuracy and confidentiality requirements.