Revenue Integrity Specialist

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.


Job Summary


Our client is seeking a skilled Data Integrity Specialist to serve as a gatekeeper for CGT updates, ensuring compliance with regulatory and coding billing guidelines. This role involves collaboration with clinical and ancillary departments and provides regulatory support to resolve billing questions.


Key Responsibilities

• Serve as a gatekeeper to ensure CGT updates comply with guidelines and reflect clinical practice.
• Collaborate with departments to facilitate proper use of CGT files and synchronize preference lists.
• Ensure system-wide compliance with regulations related to charge codes in the CGT.
• Review and route assigned edits within prescribed timeframes for resolution.
• Support and guide clinical staff to address CGT, coding, and billing questions.
• Utilize knowledge to interpret and analyze performance reports.
• Provide regulatory support to clinical charge capture specialists.

Qualifications

• CPC certification
• 3-5 years of experience in professional billing & coding
• Knowledge of CPT / HCPCS codes and reimbursement policies
• Working knowledge of Microsoft applications
• Previous experience in Obgyn
• Preferred: EPIC experience
• Must be local to MA area

Skills

• Technical: Proficient in MS applications; report creation and presentation
• Soft: Strong communication and analytical skills

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language


Medix is an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals.


* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).


Medix Overview:


With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.


* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.