Senior Coding Compliance Audit Specialist

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

Benefits offered by this job

Annual bonus

Health insurance

401(k)

Paid time off

Job summary

Privia Health is seeking a Coding Compliance Audit Specialist to perform baseline, routine, and focused audits by matching documentation with reported CPT/HCPCS and ICD-10-CM codes. The role requires CPC and CPMA certifications and deep knowledge of CMS/Medicare guidelines.

Ideal candidates will have strong communication skills and HIPAA compliance experience, with the ability to act as an internal coding expert across the organization.

Qualifications

• 5+ years of audit experience preferred.
• Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines.
• CPC certification required and CPMA certification.
• HIPAA compliance experience.
• Excellent communication skills and ability to work independently.

Responsibilities

• Conduct audits comparing medical records to CPT/HCPCS and ICD-10-CM codes.
• Research, interpret and communicate CMS/Medicare guidelines.
• Serve as internal expert on coding compliance and regulations.

Skills

Audit experience

CPT knowledge

ICD-10-CM knowledge

HCPCS knowledge

CMS/Medicare guidelines

Communication skills

Tools

MDAudit

Athena

Job description

Privia Health is seeking a Coding Compliance Audit Specialist to perform baseline, routine, and focused audits by matching documentation with reported CPT/HCPCS and ICD-10-CM codes. The role requires CPC and CPMA certifications and deep knowledge of CMS/Medicare guidelines.

Ideal candidates will have strong communication skills and HIPAA compliance experience, with the ability to act as an internal coding expert across the organization.