Remote Payment Integrity Analyst

Mosaic Life Care; Nebraska; Remote; USD 85,000 - 110,000; Full time

Job summary

Mosaic Life Care in Missouri/Northwest Missouri region seeks a Payment Validation Analyst to ensure accurate payer payments. You will analyze underpayments, price discrepancies, and denials, using Epic workflows and coordinated with Revenue Integrity to implement fixes.

Ideal candidates have at least five years in hospital financial operations, CPT/HCPCS/ICD-10 expertise, and strong data analysis and communication skills. Travel to off-site locations may be required.

Qualifications

• Bachelor's degree required; healthcare experience preferred.
• Minimum five years in hospital financial operations including reimbursement and coding.
• In-depth knowledge of CPT, HCPCS, ICD-10 and Medicare reimbursement.

Responsibilities

• Analyze contractual underpayments and resolve daily encounters in Epic WQs.
• Identify root causes for price/contract discrepancies and implement corrections.
• Lead rebill projects focused on recoupment of underpayments.
• Serve as subject matter expert on payer reimbursements and contracts.
• Research non-covered/denied charges and assist with appeals.
• Monitor re-billing accounts to ensure proper payment.
• Prepare monthly measurement reports using Epic to inform leadership.

Skills

Data entry

Calculations

Communication

Analytical thinking

Attention to detail

Problem solving

Epic WQs

Education

Bachelor's Degree

High School Diploma

Tools

Epic Contracts Module

Epic

Job description

Mosaic Life Care in Missouri/Northwest Missouri region seeks a Payment Validation Analyst to ensure accurate payer payments. You will analyze underpayments, price discrepancies, and denials, using Epic workflows and coordinated with Revenue Integrity to implement fixes.

Ideal candidates have at least five years in hospital financial operations, CPT/HCPCS/ICD-10 expertise, and strong data analysis and communication skills. Travel to off-site locations may be required.