Lead PFS Medical Billing Specialist

🔥 2 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

⏰ Full Time

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Mosaic Life Care

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

🏥 Healthcare

💰 $250k Grant - Mosaic Life Care on 2023-08

Healthcare

Mosaic Life Care is a regional health system and medical provider based in Northwest Missouri. As a member of the Mayo Clinic Care Network, Mosaic provides a wide range of outpatient and acute care services across medical centers and clinics, offers urgent care (including an online "Hold My Spot" feature), a Community Nurse Line, online patient portal (myMosaic by MyChart), cardiac scoring screening, and patient-facing services like scheduling, billing, and medical records access. The organization emphasizes community-focused healthcare and access to Mayo Clinic expertise for local patients.

📋 Description

• Perform as proxy for the department manager as needed • Coordinate productivity and quality program standards and payer meetings • Serve as a subject matter expert for account resolutions • Monitor hospital and clinic compliance with state and federal regulations and report suspected issues • Plan and implement onboarding for new caregivers • Organize and deliver staff training and education, including individual and group sessions • Assist leaders in establishing and verifying billing and reimbursement controls • Mentor Medical Billing Specialist I and II caregivers • Analyze and resolve accounts with revenue cycle departments • Complete accurate month-end reconciliation reports • Compile reports and assist with special projects, audits, and reports • Accurately and compliantly bill claims • Meet payer timely filing deadlines • Collaborate across revenue cycle and organizational areas for accurate, timely claim billing • Research payer issues, policies, contracts, guidelines, and compliance requirements • Collaborate with payer representatives on compliant claim submissions • Analyze complex claim errors and rejections and identify solutions • Identify trends and root causes and escalate them with solution proposals • Map processes and facilitate process improvement initiatives • Design and implement onboarding and ongoing caregiver training • Perform quality reviews and act as a first escalation tier for caregiver issues • Create and maintain process and workflow documents • Attend or lead PFS meetings and coordinate follow-up resolution • Maintain relationships with PFS departments and provider representatives • Ensure billers follow correct account-processing steps and procedures • Perform other duties assigned by departmental leaders

🎯 Requirements

• H.S. Diploma - Required • Intermediate to Advanced Microsoft application skills required • Excellent oral and written communication skills • Excellent organization and time management skills, with ability to establish priorities effectively • Dependable in both production and attendance • Professional communication etiquette with internal and external departments and customers • Creative problem-solving skills • Ability to research and review payer policies, guidelines, and compliance guidelines • Medical terminology knowledge • Ability to escalate issues appropriately to leadership • Ability to work independently and multitask • Ability to analyze and interpret data and explain issues thoroughly • Ability to organize data and manage time • Ability to collaborate to resolve carrier claims processing issues • Previous leadership experience highly preferred • Associate's Degree - Preferred • 4 years of non-clinical healthcare experience, preferably in revenue cycle - Preferred • Ability to operate computers, telephones, fax machines, calculators, and copiers continuously/repetitively • Ability to sit mostly, with occasional walking and standing • Hearing, speaking, and visual skills • Limited exposure to hazards

🏖️ Benefits

• Concierge services • Employee lounge • Wellness programs • Free covered parking • Free on-site and virtual health clinics • Compensation and recognition