This is a Fully Remote Job
About Our Client:
Privia Health operates in the healthcare technology and physician enablement sector. The organization collaborates with medical groups, health plans, and health systems to optimize physician practices, enhance patient experiences, and incentivize high-value care delivery across both in-person and virtual settings. Its platform combines scalable operations with cloud-based technology to reduce unnecessary healthcare costs, improve patient outcomes, and support provider well-being.
About the Opportunity:
The CODING COMPLIANCE AUDIT & EDUCATION SPECIALIST is responsible for auditing medical records to ensure compliance with federal coding regulations and guidelines. This role plays a critical part in maintaining accurate documentation and coding practices, thereby supporting regulatory adherence and promoting high-quality healthcare delivery. The specialist also educates providers to improve coding accuracy and compliance.
Responsibilities:
Conduct baseline, routine, and focused audits comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes
Research, interpret, and communicate federal and state laws and guidelines related to CMS and Medicare
Serve as an internal expert on coding compliance issues
Prepare audit reports summarizing findings
Deliver post-audit education to individual providers and provider groups
Schedule and conduct trainings with providers and their offices
Provide feedback and ongoing education on documentation guidelines, coding principles, and related processes
Communicate audit findings and track education completion and escalation
Interact professionally with physicians, leaders, staff, and internal teams
Offer coding assessment, consultation, and issue resolution as needed
Address compliance, documentation, and coding concerns directly with providers
Perform other duties as assigned
Requirements:
Minimum of 5 years audit and provider education experience preferred
Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines
Certified Professional Coder (CPC) required; Certified Professional Medical Auditor (CPMA) preferred
Experience with MDAudit and Athena systems is a plus
Compliance with HIPAA regulations
Strong communication skills and ability to work independently
Pay Range and Compensation Package:
Base salary range is $70,000 to $80,000, excluding bonuses and benefits
Eligible for an annual bonus targeted at 15%
Compensation will be determined based on experience, education, and geographic location
Benefits & Perks:
Medical insurance
Dental insurance
Vision insurance
401(k)
Equal Opportunity Statement:
Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.