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

• Serve as proxy for the department manager as needed • Coordinate productivity and quality program standards and payer meetings • Act as a subject matter expert for account resolutions • Monitor hospital and clinic compliance with state and federal regulations and report suspected issues • Plan, coordinate, and implement onboarding for new caregivers • Organize and implement staff training and education, including one-on-one sessions, group training, and payer-guideline meetings • Assist leaders in establishing and verifying billing and reimbursement controls • Mentor caregivers, including Medical Billing Specialist I and II staff • Analyze and resolve accounts with revenue cycle departments • Ensure accurate monthly reconciliation reports • Accurately and compliantly bill claims and meet payer filing deadlines • Collaborate across revenue cycle and organizational departments for timely claim billing • Research payer policies, contracts, compliance guidelines, claim errors, and rejections • Identify trends, root causes, and solutions; escalate trends with proposals • Collaborate with payer representatives on compliant claim submissions • Assist with special projects, audits, and reports • Map processes, facilitate process improvement, and support departmental change initiatives • Serve as project manager for PFS initiatives and ongoing staff 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 internal and external relationships across PFS, hospital, clinic, and provider departments • 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 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 • Ability to organize data and manage time • Ability to collaborate to resolve carrier claims processing issues • Ability to operate computer, telephone, fax, calculator, and copier continuously/repetitively • Previous leadership experience highly preferred • 4 years of non-clinical healthcare experience, preferably in revenue cycle - Preferred • Associate's Degree - Preferred

🏖️ Benefits

• Concierge services • Employee lounge • Wellness programs • Free covered parking • Free on-site and virtual health clinics • Compensation and recognition • Health care benefits designed to meet individual employee needs