Privia Health

Coding Compliance Audit & Education Specialist

Remote, us Full-time Remote
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Job Description

Under indirect supervision, the Coding Compliance Audit/Education Specialist audits medical records for compliance with federal coding regulations and guidelines. Successful candidates will have extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines. Conduct audits (i.e. baseline, routine periodic, and focused) comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes with consideration of applicable federal and state laws, regulations, and guidelines. Research, interpret and communicate federal and state laws and guidelines pertaining to CMS and Medicare. Acts as an internal expert on coding issues to ensure compliance with state and federal regulations. Preparation of audit reports including summary of findings Conduct post-audit provider education with individual or large provider groups  Schedule trainings with provider’s offices, individual providers and groups of providers Provides feedback, initial and ongoing education and training, and technical support with regard to proper documentation guidelines, service selection, charge capture, supervision, timely submission, healthcare data accuracy, and coding principles. Communicates audit findings to providers to track education completion and escalation. Interacts professionally and effectively with physicians, leaders, staff, and internal teams. Provides coding assessment, consultation, education, and issue resolution to key stakeholders as requested. Able to have honest, difficult conversations with providers about compliance, documentation, and code assignment. Other duties as assigned

Frequently Asked Questions

What does the Coding Compliance Audit & Education Specialist role at Privia Health involve?

The Coding Compliance Audit & Education Specialist position at Privia Health in Remote, us is a full-time role. Under indirect supervision, the Coding Compliance Audit/Education Specialist audits medical records for compliance with federal coding regulations and guidelines. Successful candidates will have extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines. Conduct audits (i.e. baseline, routine periodic, and focused) comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes with consideration of applicable federal and state laws, regulations, and guidelines. Research, interpret and communicate federal and state laws and guidelines pertaining to CMS and Medicare. Acts as an internal expert on coding issues to ensure compliance with state and federal regulations.

What skills are required for Coding Compliance Audit & Education Specialist at Privia Health?

Key skills for this role include: Scala, AWS, RDS.

What is the salary for Coding Compliance Audit & Education Specialist at Privia Health?

The salary for this position is not publicly listed. You can negotiate during the interview process. Check Glassdoor or Levels.fyi for estimates.

Is the Coding Compliance Audit & Education Specialist position at Privia Health remote or on-site?

This position is Remote. You can work from anywhere, subject to the employer's remote work policy.

How do I apply for Coding Compliance Audit & Education Specialist at Privia Health?

You can apply for this position directly through the employer's careers page. Click the 'Apply Now' button on this page to be redirected to the original listing. Make sure your resume is ATS-optimized. Use SpotChange's free ATS test to check.

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About This Role

Coding Compliance Audit & Education Specialist at Privia Health is a full-time other position in Remote, us. Key skills include Scala, AWS, RDS. Education: Master's Degree preferred. Experience: 3+ years.

This role is classified as remote and is suitable for mid level-level professionals. Ghost Score 25/100 (Probably Active) indicates this listing is probably active with recent employer engagement.

To apply, visit the official application page through the Apply Now button above. SpotChange Jobs provides AI-powered career tools including resume optimization, ATS testing, interview preparation, and salary negotiation assistance.