Remote Payment Integrity Specialist

Mosaic Life Care; Indiana; Remote; USD 55,000 - 75,000; Full time

Job summary

Mosaic Life Care is seeking a Payment Validation Analyst to ensure accurate payments from payors. You will analyze underpayments, price/contract discrepancies, and support rebill projects and appeals with Epic.

Responsibilities include using Epic reports to monitor payments, maintaining contracts, and identifying root causes in coding, charging, and billing to improve reimbursement. Travel may be required.

Qualifications

• Bachelor's Degree is required.
• Minimum five years of health care experience in hospital financial operations, including reimbursement and charge master management.
• In-depth knowledge of CPT/HCPCS/ICD-10 coding and Medicare reimbursement.

Responsibilities

• Analyze contractual underpayments and resolve daily encounters in Epic WQs for underpayments.
• Resolve encounters in Epic WQ for price/contract discrepancies; implement fee schedule corrections.
• Work on rebill projects focused on recoupment of underpayments.
• Be SME on payer reimbursements and contracts; inform changes and implement as needed.
• Research non-covered or denied charges to identify root causes and assist with appeals.
• Identify coding, charging or billing issues; educate staff to resolve and monitor re-billing.
• Use Epic reports to prepare monthly measurement reports and recommendations for approval.
• Create and maintain contracts in Epic.

Skills

Data entry

Attention to detail

Communication

Education

Bachelor's Degree - Required

High School Diploma - Required

Job description

Mosaic Life Care is seeking a Payment Validation Analyst to ensure accurate payments from payors. You will analyze underpayments, price/contract discrepancies, and support rebill projects and appeals with Epic.

Responsibilities include using Epic reports to monitor payments, maintaining contracts, and identifying root causes in coding, charging, and billing to improve reimbursement. Travel may be required.