Analysis Skills, Auditing, Benchmarking, Billing, Certified Professional Coder (CPC), Charge Capture, Communication Skills, Content Management Systems (CMS), Data Analysis, Documentation, Epic Certification, EpicCare Ambulatory, Healthcare Common Procedure Coding System (HCPCS), Maintain Compliance, Medical Coding, Microsoft Office, Performance Analysis, Primary Care, Regulations, Regulatory Compliance, Revenue Analysis, Training/Teaching
Revenue Integrity Specialist (Professional Billing)
Position Overview
Serves as a Charge Generation Tracker (CGT) and regulatory resource to ensure compliance with coding and billing guidelines. Acts as a primary resource for providers and staff, supporting revenue integrity, charge capture, and coding accuracy.
Position Details
Location: Worcester, MA (Primarily Remote)
Schedule: Monday – Friday, 8:00 AM – 5:00 PM
Employment Type: Full-Time, Exempt
Key Responsibilities
- Ensure Charge Generation Tracker (CGT) compliance with regulatory and coding guidelines
- Review billing edits and route for resolution
- Provide coding and billing guidance to clinical and administrative teams
- Analyze data to identify revenue integrity opportunities
- Collaborate with departments to optimize charge capture workflows
- Develop and conduct training on coding and documentation
- Monitor CMS and payer updates and ensure compliance
- Perform audits to improve documentation and coding accuracy
- Support reporting, benchmarking, and performance analysis
Qualifications
Required:
- Associate’s degree
- Certified Professional Coder (CPC)
- EPIC Ambulatory certification within 12 months
- 3–5 years of professional billing and coding experience
- Strong knowledge of CPT/HCPCS and payer regulations
- Strong analytical and communication skills
- Proficiency in Microsoft Office
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Top Prospect Group LLC
Top Prospect Group founders and management team offer more than 75 years of combined experience in Information Technology, Creative & Marketing, and Finance & Accounting staffing and solutions. Our fundamental goal is to build successful relationships resulting in accurate job and prospect representations. We meet with those we work with face-to-face to garner a better understanding of candidate or client requirements. By leveraging our experience and market insight, we are able to provide a more consistent recruitment process. Motivated by a partnership philosophy, our staff possesses a deep understanding of how to forge mutually beneficial long-term relationships. We believe in what we do and continuously strive for excellence.
20 to 49 employees
Staffing/Employment Agencies
http://www.topprospectgroup.com/