Lead PFS Medical Billing Specialist

Mosaic Life Care

. Serve 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 revenue cycle management, including billing, compliance, and training. Proficient in coordinating staff development and ensuring adherence to regulatory standards while fostering effective communication across departments.

Highest-signal resume keywords

Revenue Cycle ManagementMedical Terminology KnowledgeIntermediate to Advanced Microsoft SkillsExcellent Oral and Written CommunicationLeadership Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Billing and Reimbursement ControlsData Analysis and InterpretationProcess Improvement MappingQuality Review PerformanceClaim Submission Compliance

Soft Skills

Creative Problem-SolvingExcellent Organization and Time ManagementDependabilityProfessional CommunicationAbility to Multitask

Tools & Technologies

ComputerTelephoneFaxCalculatorCopier

Industry Keywords

Healthcare CompliancePayer PoliciesAccount ResolutionsStaff Training and EducationNon-Clinical Healthcare Experience

About the role

Key responsibilities & impact

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

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 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

Comp & perks

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