Revenue Integrity Specialist

Medical Coding Educator & Auditor

Salary: Ranges based on experience (65,000 - 95,000)


Location: Fully Remote - Local to New England


Travel: If needed - Occasional on-site requirement (driving distance preferred)

Employment Type: Permanent, Direct Hire

Position Summary

UMass Memorial Health is seeking a Senior Revenue Integrity Specialist to serve as a subject matter expert in Professional Fee (ProFee) Coding, Auditing, and Physician Education. This highly visible role supports more than 400 physicians across multiple specialties and requires a unique blend of advanced coding expertise, audit experience, and the ability to confidently educate and present to both small groups and large physician audiences.

The ideal candidate is a strong coding professional who can audit documentation, identify revenue integrity opportunities, defend coding decisions, and lead physician education initiatives focused on coding accuracy, compliance, and documentation improvement.

Key Responsibilities

• Perform professional fee coding audits and quality reviews across multiple specialties.
• Conduct physician education on coding, documentation, compliance, and billing best practices.
• Deliver presentations and training sessions ranging from one-on-one coaching to large physician groups.
• Review and analyze coding trends, identify revenue opportunities, and recommend process improvements.
• Support annual coding updates, regulatory changes, and major audit initiatives.
• Research and interpret CPT, HCPCS, CMS, payer, and reimbursement guidelines.
• Partner with providers, revenue cycle teams, compliance, finance, and operational leaders to ensure coding accuracy and regulatory compliance.
• Support onboarding of new hospitals and physician groups, including potential onsite education and training.
• Assist with adoption and optimization of emerging technologies and AI-driven coding tools.
• Serve as a coding resource and regulatory expert for providers and clinical staff.

Required Qualifications

• AAPC Certified Professional Coder (CPC) or equivalent professional coding certification required.
• 3-5+ years of Professional Fee (ProFee) coding experience.
• Strong auditing and physician education experience.
• Expertise in:
  • Evaluation & Management (E/M) coding and leveling
  • Medical Decision Making (MDM) calculations
  • CPT, HCPCS, and payer guidelines
  • Documentation review and coding compliance
• Experience presenting coding findings and defending coding decisions with physicians.
• Strong communication, presentation, and relationship-building skills.
• Experience with Epic and coding/revenue cycle systems (3M preferred).
• Advanced Microsoft Office and presentation development skills.

Preferred Qualifications

• Multi-specialty coding experience, including primary care, OB/GYN, and specialty practices.
• Revenue Integrity or Charge Capture background.
• Experience supporting large healthcare systems.
• Exposure to AI-enabled coding solutions and workflow automation.
• Prior educator, trainer, or physician-facing consulting experience.

Ideal Candidate

• The successful candidate is a strong coder-educator hybrid who can confidently engage physicians, present to audiences of all sizes, and drive coding accuracy across a complex health system. They possess a strong personality, can navigate varied physician communication styles, and are comfortable influencing change through education, audits, and data-driven recommendations.

Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico.

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