Mosaic Life Care

Nurse

• Perform inpatient admission, concurrent, and retrospective reviews for Medicare, Medicaid, managed care, and self-pay patients using CMS guidelines
• Use a national medical necessity tool to assess inpatient-level-of-care or observation appropriateness
• Stay current on regulatory changes affecting acute-care delivery or reimbursement
• Identify and record progression-of-care and patient-flow barriers and communicate denial-of-stay information to the care team
• Collaborate with physicians and APRNs on resource utilization, status determination, and transitions of care
• Educate patient-care teams on access to and use of various levels of care
• Represent utilization management at committees, professional organizations, and physician groups
• Promote accurate medical documentation of findings, interventions, complications, comorbidities, quality and safety indicators, and continuing-stay needs
• Confer with attending physicians and the Physician Advisor regarding medically unnecessary inpatient treatment
• Coordinate appeals of denials
• Serve as a resource for physicians, nurses, billing office, and external departments on coverage and compliance issues
• Participate in program development and process improvement efforts
• Perform other duties as assigned

Utilization Review, Registered Nurse – Weekend

Analyst

• Support and configure the assigned healthcare application
• Assist, train, and support customers with application operation and administration
• Troubleshoot application issues and work with vendors on resolution
• Partner with customers to improve understanding of available tools and operational efficiencies
• Create documentation and assist Technology teams with issues and problems
• Report project issues and accomplishments to the application manager
• Deliver work products meeting project scope and departmental application configuration/development guidelines
• Analyze and document workflows, regulatory requirements, operational procedures, and hospital or departmental policies
• Participate in planning, development, implementation, maintenance, support, and evaluation of clinical or business application systems
• Perform system design, document design decisions, redesign and document workflows, collect data, build databases, test, and troubleshoot
• Participate in team and project meetings and work closely with team members
• Maintain competency in the assigned application or technical area
• Work with customers and Epic team members to deliver solutions
• Test module updates, enhancements, and new releases
• Perform other duties as assigned

Epic Clinical Application Analyst I

Medical Billing and Coding

• 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

Lead PFS Medical Billing Specialist

• 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

• Assign ICD-10-CM and/or CPT codes for outpatient referrals, recurring or therapy services, and non-interventional radiology
• Perform primary care clinic coding and/or coding for a single specialty
• Code procedures and diagnoses according to Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards
• Participate in workshops, conferences, and in-services for professional development
• Communicate with providers and query them to ensure maximum documentation specificity
• Work with Patient Financial Services to verify and modify charges and coding for accurate documentation and payer compliance
• Respond to edits to ensure State HIDI data accuracy
• Perform other assigned duties

Clinic/Outpatient Coder I

Financial Planning and Analysis

• Coordinate PFS initiatives and facilitate process improvement
• Collaborate with the PFS Manager to map processes, conduct readiness assessments, implement changes, and improve departmental standards
• Serve as project manager for PFS initiatives and staff training and education
• Coordinate, assess, document, and communicate operational actions, irregularities, and continuing needs
• Provide status updates, reports, project summaries, and presentations to the PFS Manager
• Serve as a proxy for the PFS Manager when needed
• Assist with PFS change management communication plans and initiatives
• Assist RCIRR Leadership with revenue cycle training and education programs
• Maintain relationships with PFS and hospital/clinic departments
• Attend PFS meetings, capture follow-up items, and coordinate resolutions
• Research payer policies and contracts and provide updated information to PFS teams and leadership
• Validate payer contract information in software and confirm reimbursement aligns with contracted rates
• Mentor caregivers and complete special projects as directed

Patient Financial Services Coordinator

• Develop, evaluate, and administer physician and advanced practice provider compensation strategies, models, and programs
• Collaborate with executive leadership, legal counsel, and stakeholders to develop, revise, and manage employment and medical director agreements
• Perform financial modeling, compensation valuations, benchmarking, and data analysis
• Manage payroll-related compensation changes, incentive calculations, productivity reconciliation, call pay, shift payments, contractor payments, and separation obligation recoveries
• Conduct provider productivity analysis, including wRVU validation, unlisted code evaluation, manual productivity calculations, and revenue cycle collaboration
• Administer provider compensation surveys and market benchmarking initiatives
• Develop and distribute provider statements, scorecards, educational materials, and leadership reports
• Serve as the primary compensation, productivity, benefits, and employment liaison and subject matter expert
• Manage provider onboarding, including compensation plan education, benefits orientation, HR requirements, and system access coordination
• Oversee provider retention and incentive programs
• Ensure accurate administration, implementation, and payment processing of provider agreements and compensation programs
• Reconcile compensation and productivity data, prepare accruals and journal entries, and support financial reporting and month-end close
• Provide analytical, operational, and strategic support to leadership and perform special projects

Provider Compensation Analyst

Data Coordinator

• Process and maintain donor and gift data daily
• Accurately record gifts using supporting documentation, donor intent, fund allocation, program coding, and pledge schedules
• Maintain, optimize, and ensure integrity of the Blackbaud Raiser’s Edge NXT CRM donor database
• Run reports, oversee dashboards, conduct audit confirmations, and support data quality initiatives
• Prepare daily gift deposits and assist with reconciliations
• Import careGIVER voluntary payroll deductions into Raiser’s Edge
• Produce quarterly fund balance memos and distribute reports to designated fund account representatives
• Train staff on data-entry policies, procedures, and protocols; update documentation and training materials
• Respond to gift-making inquiries and coordinate with accounting/finance on fund setup and transfers
• Investigate and resolve fund-related issues
• File and maintain complete, retrievable gift batches and pledge documentation
• Support development staff with transaction processing, mailing lists, and periodic fundraising reports
• Generate gift receipts and acknowledgments; manage pledge reminders and outstanding pledges
• Prepare end-of-year tax letters through Raiser’s Edge
• Perform additional duties as assigned
• Work closely with philanthropy offices and accounting/finance staff to ensure accurate transaction recording, timely receipting, and accessible data

Gifts and Data Processing Coordinator

IT Specialist

• Own day-to-day administration and configuration of Jira Service Management
• Maintain and optimize workflows, request types, queues, automations, approvals, and notifications
• Ensure ticket routing and assignment logic minimizes manual triage
• Maintain platform standards, configuration governance, and documentation
• Support Jira Agile Scrum and Kanban boards and Jira Software/Jira Service Management integrations
• Own operational execution of Incident, Change, and Problem Management
• Define priority models, escalation paths, and resolution standards
• Support Change Management execution, including CAB preparation and coordination
• Enable problem identification, root cause analysis, and trend reporting
• Design, configure, and maintain SLA policies
• Monitor SLA compliance and service performance metrics
• Produce operational and leadership dashboards and reports
• Maintain service and configuration item structures in JSM and CMDB
• Ensure accurate linkage among incidents, changes, requests, services, and assets
• Lead discovery and documentation of current-state ITSM processes
• Define future-state workflows and improvement roadmaps
• Maintain and prioritize an ITSM improvement backlog
• Support user acceptance testing for configuration changes
• Develop and deliver role-based training
• Maintain ITSM process documentation and runbooks
• Act as the primary ITSM contact for IT and business stakeholders
• Translate operational requirements into platform and process changes
• Partner with leadership to align ITSM capabilities with organizational priorities
• Perform other duties as assigned

IT Service Management Specialist

Navigator

• Conduct standardized screening and intake to identify clinical, behavioral, and social needs
• Document findings, referrals, and follow-up in the Community Information Exchange and other Hub-approved systems
• Manage closed-loop referrals and warm handoffs across healthcare and community partners
• Confirm service receipt, document outcomes, and re-engage residents when referrals or services are incomplete
• Engage Medicaid members, dually eligible residents, and other high-need residents through calls, field visits, community outreach, and partner-site follow-up
• Provide health education, care navigation, and reinforcement of care plans
• Help residents access primary care, behavioral health, women’s health and prenatal care, EPSDT services, chronic disease management, healthy homes services, home visiting, pharmacy services, telehealth, and non-emergency medical transportation
• Identify, prioritize, and resolve barriers involving appointments, transportation, medication access, benefits or insurance, food and nutrition, and digital access
• Own an assigned caseload and maintain structured follow-up until services are completed, needs are resolved, or care is transitioned
• Participate in Hub huddles, case reviews, and partner meetings
• Track and report outreach, screening, referral, and outcome data
• Escalate urgent clinical, behavioral health, or safety concerns to licensed staff or supervisors
• Maintain a visible community presence through outreach activities, partner-site engagement, and local events
• Work as a non-clinical navigator; do not diagnose, prescribe, or provide licensed clinical treatment

Utilization Review, Registered Nurse – Weekend

Epic Clinical Application Analyst I

Lead PFS Medical Billing Specialist

Lead PFS Medical Billing Specialist

Clinic/Outpatient Coder I

Patient Financial Services Coordinator

Provider Compensation Analyst

Gifts and Data Processing Coordinator

IT Service Management Specialist

Program Navigator