Medix · 1 week ago
Chart Review Specialist
New York, NY, US
Full-time
Hybrid
Senior Level
$45/hr - $50/hrMedix is partnering with a Healthcare Technology organization to identify a Senior Medical Coding & Audit Specialist to support advanced medical record audits, revenue integrity initiatives, and audit validation efforts. This hybrid, contract role is intended for highly experienced coding and auditing professionals who will act as a subject matter expert and collaborate closely with technology and analytics teams to improve automated decision-making.
MedicalPharmaceuticalWholesale
Responsibilities
Perform detailed medical record audits to ensure compliance with medical necessity guidelines, modifier usage, and payer-specific billing requirements
Analyze complex billing scenarios, including Medically Unlikely Edits (MUEs) and specialty-specific carve-outs, identifying issues not captured by automated rules engines
Serve as a coding and auditing SME, providing guidance on specialty standards, payer contracts, and regulatory requirements
Collaborate with technology and analytics teams as an "Expert-in-the-Loop," delivering clear, actionable feedback to improve data validation and automated models
Review entire patient charts to identify underbilling trends, missed revenue opportunities, and proactive denial risks
Translate clinical reasoning and audit findings into structured insights that support process optimization and continuous improvement initiatives
Qualification
Required
Active AAPC or AHIMA certification (CPC, CPMA, or CCS-P required)
Extensive experience conducting medical record audits, with advanced understanding of medical necessity guidelines and modifier logic
Strong knowledge of MUEs, specialty-specific carve-outs, and payer/contract-specific billing rules
Demonstrated ability to interpret complex reimbursement and regulatory guidance with attention to nuance and detail
Experience collaborating cross-functionally with technology, analytics, or data teams
Strategic mindset with the ability to assess revenue cycle performance holistically
Ability and willingness to work onsite in Midtown Manhattan three days per week (Monday, Tuesday, Thursday)
Preferred
Experience supporting or training automated auditing or revenue cycle technology platforms
Strong analytical skills with the ability to identify trends, root causes of denials, and underpayment risks
Excellent communication skills, particularly in translating complex clinical and regulatory findings into actionable feedback
Benefits
Medical, dental, vision, short-term disability, and life insurance
Benefits eligibility after averaging 30 hours/week for 4 consecutive weeks
Company
Medix
At Medix Distribution, we have designed solutions to meet the medical needs for the betterment of society as a whole.
Founded in 2007
11-50 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase