Remote Payment Validation & Reimbursement Specialist

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

Benefits offered by this job

Concierge services

Employee lounge

Wellness programs

Free parking

Job summary

Mosaic Life Care is seeking a Payment Validation Analyst to ensure accurate payor reimbursement. You will work under the Director of Revenue Integrity, analyzing underpayments and discrepancies, and preparing actionable reports in Epic.

This role requires 5 years in health care finance, CPT/HCPCS/ICD-10 knowledge, and Epic WQ proficiency. Remote work options exist for specific states, with travel to off-site locations as needed.

Qualifications

• Bachelor's degree required; hospital finance experience preferred.
• Minimum five years in health care operations; reimbursement, coding and charge audit knowledge.
• Strong CPT/HCPCS/ICD-10 knowledge and related Medicare reimbursement understanding.
• Epic experience and ability to use Epic WQs and related tools.

Responsibilities

• Analyze contractual underpayments and resolve daily encounters in Epic WQs.
• Investigate price/contract discrepancies and implement fee schedule corrections.
• Lead rebill projects focused on recoupment of underpayments.
• Serve as subject matter expert on payer reimbursements and contracts; implement changes as needed.
• Research non-covered or denied charges and assist with appeals.
• Identify coding, charging, or billing issues and educate staff to resolve them.
• Use Epic reports to prepare monthly findings and recommendations for leadership.

Skills

Data entry

Communication

Physical stamina

Analytical thinking

Confidentiality

Education

Bachelor's degree

High School Diploma

Tools

Epic Contracts Module

Job description

Mosaic Life Care is seeking a Payment Validation Analyst to ensure accurate payor reimbursement. You will work under the Director of Revenue Integrity, analyzing underpayments and discrepancies, and preparing actionable reports in Epic.

This role requires 5 years in health care finance, CPT/HCPCS/ICD-10 knowledge, and Epic WQ proficiency. Remote work options exist for specific states, with travel to off-site locations as needed.