Remote Revenue Integrity & Payment Validation Specialist

Mosaic Life Care; Lorida (FL); Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Concierge services

Employee lounge

Wellness programs

Free parking

On-site health clinics

Job summary

Mosaic Life Care in Missouri is seeking a Payment Validation Analyst to ensure accurate payment from payors. The role centers on analyzing underpayments in Epic WQs, resolving discrepancies, and guiding corrective actions with the Revenue Integrity team.

You’ll review CPT/HCPCS coding and fee schedules, coordinate rebill projects, and prepare monthly reports. Travel to off-site locations may be required.

Qualifications

• Bachelor's degree required in a related field.
• Minimum five years' healthcare finance experience in hospital operations.
• Knowledge of CPT/HCPCS/ICD-10 coding and reimbursement.

Responsibilities

• Analyze contractual underpayments and resolve daily encounters in Epic WQs.
• Investigate price/contract discrepancies; implement fee schedule corrections.
• Lead rebill projects to recoup underpayments.
• Serve as SME on payer reimbursements; update staff on changes.
• Research non-covered/denied charges and assist with appeals.
• Create monthly Epic-based measurement reports and recommendations.
• Maintain contracts in Epic and assist startup for new programs.
• Research CPT/revenue code issues identified by PFSS/Coding/RI.
• Coordinate routine projects and educate staff on billing issues.
• Other duties as assigned.

Skills

Communication skills

Data analysis

Epic WQs proficiency

Problem solving

Attention to detail

Healthcare reimbursement knowledge

Education

Bachelor's Degree

High School Diploma

Tools

Epic

Job description

Mosaic Life Care in Missouri is seeking a Payment Validation Analyst to ensure accurate payment from payors. The role centers on analyzing underpayments in Epic WQs, resolving discrepancies, and guiding corrective actions with the Revenue Integrity team.

You’ll review CPT/HCPCS coding and fee schedules, coordinate rebill projects, and prepare monthly reports. Travel to off-site locations may be required.