Remote Payment Validation & Reimbursement Analyst

Mosaic Life Care; Athens (GA); Remote; USD 65,000 - 90,000; Full time

Job summary

Mosaic Life Care is seeking a Payment Validation Analyst to ensure accurate reimbursement by payors. The role involves reviewing contractual underpayments, resolving Epic WQ discrepancies, and leading rebill projects to recoup underpayments.

You will act as a subject matter expert on payer reimbursements, monitor changes, and assist with denials and appeals while promoting accurate payment and compliance across Revenue Integrity processes.

Qualifications

• Essential Technical/Motor Skills: input data, type, manipulate calculator and small business equipment, speak clearly and professionally, answer telephone, copying.
• Interpersonal Skills: oral and written communication with staff, leadership, physicians and consultants on an individual basis as well as teams.
• Essential Physical Requirements: lifting, moving, reaching, bending, stooping, standing, walking, typing, operating small business equipment.
• Essential Mental Abilities: analyze, synthesize, evaluate, comprehend, explain, forecast, interpret, manipulate numbers, interpret data, calculate, organize, plan, presentations.
• Essential Sensory Requirements: eyesight, hearing.
• Exposure to Hazards: electrical output of personal computer, eye/neck strain.
• Other Skills and Abilities: highly energetic, self-starter; identify areas of concern; accuracy; confidentiality.

Responsibilities

• Analyze contractual underpayments and resolve daily encounters in Epic WQs; identify root causes and implement corrective actions.
• Resolve encounters in Epic WQ for price/contract discrepancies; collaborate to implement fee schedule corrections.
• Lead rebill projects focused on recoupment of underpayments.
• Serve as subject matter expert on payer reimbursements and contracts; monitor payer changes and implement as needed.
• Research non-covered or denied charges to identify root causes; assist with appeals.
• Identify coding, charging, and billing issues/patterns causing inaccurate payments; educate staff and track re-billing for proper payment.

Skills

Data entry

Typing

Phone etiquette

Communication

Education

Bachelor's Degree - Required

High School Diploma - Required

Job description

Mosaic Life Care is seeking a Payment Validation Analyst to ensure accurate reimbursement by payors. The role involves reviewing contractual underpayments, resolving Epic WQ discrepancies, and leading rebill projects to recoup underpayments.

You will act as a subject matter expert on payer reimbursements, monitor changes, and assist with denials and appeals while promoting accurate payment and compliance across Revenue Integrity processes.