Revenue Integrity Specialist: Coding & Compliance Expert

Medix™; Worcester (MA); On-site; USD 90,000 - 120,000; Full time

Job summary

Medix is seeking a CGT Specialist to ensure regulatory compliance for coding, billing, and third-party guidelines across the system. The role acts as the primary resource for clinical staff, providers, and administration on coding and billing matters.

You will lead CGT updates, perform audits, and develop training materials to improve documentation and charge capture. This position supports revenue integrity and requires EPIC proficiency and CPC certification.

Qualifications

• CPC certification required.
• Proficient in EPIC and Microsoft Office.
• 3-5 years professional billing and coding experience.
• Experience with OB/GYN billing and coding.
• Strong knowledge of CPT/HCPCS codes and payer policies.
• Ability to create and present reports to physicians.

Responsibilities

• Maintain CGT in compliance with federal, state and payer regulations and synchronize with IT applications.
• Review and resolve billing/coding edits within prescribed timeframes and coordinate with staff for resolution.
• Provide regulatory support and guidance on coding and billing to providers and staff.
• Develop and deliver educational courses on coding and billing guidelines.
• Lead annual CPT/CMS reviews and perform audits of patient accounts.

Skills

Billing experience 3-5 yrs

OB/GYN billing

CPT/HCPCS knowledge

Third-party policies

Report creation

Education

CPC certification

Tools

EPIC

Microsoft Office

Job description

Medix is seeking a CGT Specialist to ensure regulatory compliance for coding, billing, and third-party guidelines across the system. The role acts as the primary resource for clinical staff, providers, and administration on coding and billing matters.

You will lead CGT updates, perform audits, and develop training materials to improve documentation and charge capture. This position supports revenue integrity and requires EPIC proficiency and CPC certification.