Remote Revenue Integrity & Payment Validation Specialist

Mosaic Life Care

Clifton (TX)

Remote

USD 65,000 - 95,000

Full time

7 days ago

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Benefits offered by this job

Concierge services

Employee lounge

Wellness programs

Free covered parking

On-site health clinics

Virtual health clinics

Job summary

Mosaic Life Care in Texas is seeking a Payment Validation Analyst to ensure accurate payments from payors, with focus on line-level validation in Epic workflows. You will analyze contractual underpayments, price discrepancies, and rebill projects to recoup underpayments, working under the Director of Revenue Integrity.

The role requires five years of healthcare finance experience, CPT/HCPCS/ICD-10 knowledge, and Epic system proficiency.

Qualifications

Bachelor's degree required in a healthcare-related field or equivalent experience.
Minimum five years of health care experience with hospital financial operations including reimbursement, coding and charge master development.
Experience with Epic WQs and payer contracts preferred.

Responsibilities

Analyze contractual underpayments and resolve daily encounters in Epic WQs.
Investigate price/contract discrepancies and implement fee schedule corrections.
Lead rebill projects to recoup underpayments and educate staff on findings.
Research non-covered/denied charges and assist with appeals.
Identify coding and billing issues and monitor accounts for re-billing to ensure proper payment.