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

Extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines
Ability to conduct audits comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes
Knowledge of applicable federal and state laws, regulations, and guidelines
Ability to 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

Privia Health is hiring a Coding Compliance Audit & Education Specialist