Job Description
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)
*Monthly onsite presence is required.
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
#TPGHartford
Numbers & Facts
| Location | Greater Boston, MA |
| Industry | Staffing/Employment Agencies |
| Company Size | 20 to 49 employees |
| Year Founded | 2009 |
| Website | http://www.topprospectgroup.com/ |
About Company
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.
Skills
- Analysis Skillsunmatched
- Auditingunmatched
- Benchmarkingunmatched
- Billingunmatched
- Certified Professional Coder (CPC)unmatched
- Charge Captureunmatched
- Communication Skillsunmatched
- Content Management Systems (CMS)unmatched
- Data Analysisunmatched
- Documentationunmatched
- Epic Certificationunmatched
- EpicCare Ambulatoryunmatched
- Healthcare Common Procedure Coding System (HCPCS)unmatched
- Maintain Complianceunmatched
- Medical Codingunmatched
- Microsoft Officeunmatched
- Performance Analysisunmatched
- Primary Careunmatched
- Regulationsunmatched
- Regulatory Complianceunmatched
- Revenue Analysisunmatched
- Training/Teachingunmatched
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