Remote - Payment Validation Analyst

Mosaic Life Care

1d • $54,038 - $81,058 • Remote

About The Position

Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. Responsible for ensuring accurate payment is received from payors, including line level payment validation where appropriate. This position works under the supervision of the Director of Revenue Integrity, and is employed by Mosaic Life Care.

Requirements

• Bachelor's Degree, and H.S. Diploma are both required.
• 5 Years of Health care experience. Minimum five years' experience and knowledge of hospital financial operations including reimbursement, Medical Billing, Charge Master Development and Maintenance, Medical Records/Coding and Charge Audit experience is required.
• 5 Years of Broad based knowledge of hospital financial operations including reimbursement, coding and charge master development and maintenance is required.
• 5 Years of In-depth knowledge of CPTs, HCPCs and ICD-10 medical coding, and related APC Medicare reimbursement is required.

Nice To Haves

• Epic Contracts Module Certification is preferred.

Responsibilities

• Responsible for analyzing contractual underpayments. Identify and resolve daily encounters holding in Epic WQs for contractual underpayments. Identify root cause and work on corrective action implementation.
• Responsible for resolving encounters in Epic WQ for price/contract discrepancy. Identify root cause and work with CDM Analyst/Revenue Integrity Analyst to implement fee schedule correction, and/or identify root cause causing the discrepancy.
• Works on rebill projects focused on recoupment of underpayments.
• Subject matter expert regarding payer reimbursements and contracts. Be informed of changes to payer reimbursement and work with CDM Analyst and/or Revenue Integrity Analysts to implement changes, if and as needed.
• Other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees