Coding Compliance Audit & Education Pro

Privia Health; United States; On-site; USD 70,000 - 80,000; Full time

Benefits offered by this job

Annual bonus

Benefits package

Job summary

Privia Health seeks a Coding Compliance Audit/Education Specialist to audit medical records for compliance with federal coding regulations, including CPT, ICD-10, and HCPCS codes. Under indirect supervision, you will interpret guidelines and educate providers on proper documentation and code assignment.

You will conduct baseline and focused audits, prepare reports, and lead post-audit trainings for providers and groups, ensuring accurate coding and regulatory compliance across the organization.

Qualifications

• Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines.
• Proven experience auditing medical records for compliance with federal regulations.
• HIPAA rules compliance is mandatory.
• Excellent communication and independent work capability.
• Certified Professional Coder (CPC) and CPMA required.

Responsibilities

• Audit medical records for compliance with CPT/HCPCS and ICD-10-CM codes.
• Research and communicate CMS/Medicare guidelines and state laws.
• Act as internal coding expert to ensure regulatory compliance.
• Prepare audit reports with findings and recommendations.
• Conduct post-audit provider education and trainings.
• Provide feedback and ongoing coding education to stakeholders.
• Interact professionally with physicians and staff.

Skills

Audit

Provider education

CPT

ICD-10

HCPCS

HIPAA

Communication

Education

CPC

CPMA

Tools

MDAudit

Athena

Job description

Privia Health seeks a Coding Compliance Audit/Education Specialist to audit medical records for compliance with federal coding regulations, including CPT, ICD-10, and HCPCS codes. Under indirect supervision, you will interpret guidelines and educate providers on proper documentation and code assignment.

You will conduct baseline and focused audits, prepare reports, and lead post-audit trainings for providers and groups, ensuring accurate coding and regulatory compliance across the organization.