Lead PFS Medical Billing Specialist

Mosaic Life Care

. Perform as proxy for the department manager as needed .

Posted 9/21/2026full-timeRemote • Missouri • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical billing and revenue cycle management, with a strong focus on compliance, training, and process improvement. Capable of analyzing complex claims and collaborating effectively with various stakeholders to ensure accurate billing and reimbursement.

Highest-signal resume keywords

Medical Billing ExpertiseRevenue Cycle ManagementCompliance MonitoringStaff Training and MentoringData Analysis and Reporting

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical TerminologyClaims ProcessingMonth-End ReconciliationPayer Policy ResearchProcess Improvement MappingData AnalysisBilling and Reimbursement ControlsAccount ResolutionQuality ReviewOnboarding Implementation

Soft Skills

Excellent Communication SkillsCreative Problem-SolvingOrganizational SkillsTime ManagementDependability

Tools & Technologies

Microsoft ApplicationsComputersTelephonesFax MachinesCalculatorsCopiers

Industry Keywords

Healthcare ComplianceRevenue CyclePayer RelationsNon-Clinical Healthcare ExperienceLeadership Experience

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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