Lead PFS Medical Billing Specialist

Mosaic Life Care

. Collaborate with managers to map existing processes and facilitate process improvement .

Posted 10/7/2026full-timeRemote • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in process improvement, project management, and medical billing within the revenue cycle. Proficient in analyzing complex claims and ensuring compliance with payer guidelines while effectively mentoring team members.

Highest-signal resume keywords

Process ImprovementProject ManagementMedical BillingPayer Guidelines ResearchTeam Mentoring

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical TerminologyData AnalysisWorkflow DocumentationClaims ReviewBilling ComplianceMicrosoft ApplicationsProblem-SolvingAccount ReconciliationTraining Program DevelopmentQuality Review

Soft Skills

Excellent CommunicationOrganization SkillsTime ManagementDependabilityCreative Problem-Solving

Tools & Technologies

ComputersTelephonesFax MachinesCalculatorsCopiers

Industry Keywords

Revenue CycleHealthcare ExperienceNon-ClinicalPFS InitiativesEscalation Procedures

About the role

Key responsibilities & impact

Collaborate with managers to map existing processes and facilitate process improvement
Serve as project manager for PFS initiatives and ongoing staff training and education
Design, develop, configure, and implement onboarding and caregiver training programs
Perform as proxy for the manager and conduct quality reviews
Mentor Medical Billing Team members and act as a first escalation tier
Review and analyze complex claims, researching payer guidelines and collaborating with provider representatives and departmental leaders
Create and maintain process and workflow documents
Research and resolve complex billing questions, discrepancies, claim errors, and rejections
Research payer policies and contracts and provide updated information to PFS teams and leadership
Collaborate with revenue cycle departments to resolve billing and compliance issues
Attend or lead PFS meetings and coordinate follow-up resolution
Maintain relationships with PFS departments and provider representatives
Analyze and resolve accounts and systematic issues
Ensure billers follow correct account-processing steps and procedures
Ensure accurate billing, timely filing, month-end reconciliation, and compliance with payer guidelines
Assist with special projects, audits, reports, and departmental reporting

Requirements

What you’ll need

Remote employment limited to candidates residing in Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, or Virginia
Intermediate to Advanced Microsoft application skills
Excellent oral and written communication skills
Excellent organization and time management skills; ability to establish priorities effectively
Dependable in 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 interact virtually with the team
Ability to analyze and interpret data and explain issues thoroughly
Ability to organize data and collaborate to resolve carrier claims processing issues
Ability to operate computers, telephones, fax machines, calculators, and copiers continuously/repetitively
H.S. Diploma - Required
Associate's Degree - Preferred
Four years of non-clinical healthcare experience, preferably in revenue cycle - Preferred
Previous leadership experience highly preferred

Benefits

Comp & perks

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