Job Description
Job Description
Summary
Serve as a critical Charge Generation Tracker (CGT) Specialist and regulatory gatekeeper, ensuring strict compliance with all coding, billing, and third-party guidelines. This role is essential for revenue integrity and correct charge capture across the system. You will act as the primary resource for clinical staff, providers, and administration on coding and billing regulatory matters.
Key Responsibilities
- Regulatory Compliance & CGT Management: Maintain and update the CGT in compliance with federal, state, and payer regulations, ensuring accurate reflection of clinical practice and proper synchronization with IT applications.
- Edit Review & Resolution: Review and resolve assigned billing/coding edits within prescribed timeframes, routing issues to appropriate owners and collaborating with clinical/charge capture staff for resolution. Monitor daily edit reports and address delinquencies.
- Expert Support & Resource: Provide expert regulatory support, guidance, and research on coding, billing, and charge capture to providers, clinical charge capture specialists, and administrative staff. Act as the primary subject matter expert for the organization.
- Education & Training: Develop and conduct educational courses, seminars, and training materials for physicians, clinicians, and billing staff on professional documentation, coding, and billing guidelines.
- Audit & Monitoring: Lead annual regulatory reviews (CPT, CMS updates) and perform quality audits of patient accounts to identify opportunities for improvement in documentation, charge capture, and coding. Monitor key coding and billing publications for timely compliance.
Requirements
- CPC certification
- EPIC
- 3-5 years of experience in professional billing & coding
- Knowledge of CPT / HCPCS codes and third-party reimbursement policies
- Working knowledge of Microsoft applications; ability to create and present reports to physicians
Schedule/Shift: Monday-Friday 8am-5pm (EST)
**PLEASE NOTE**: This is a Hybrid position so candidates must be from the New England area, preferably in MA. Candidates must be able and willing to come on-site for at-the-elbow support, especially during new practice implementations
For California Applicants:
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).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. 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.
Company DescriptionHere at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?
Company Description
Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?