Medical Coding Educator & Auditor

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.

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.
• 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.

Benefits

Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide.

About Everforth Apex

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.

Equal Opportunity Employer

We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law.