Coding Compliance Audit Specialist

5+ years of audit experience is preferred.

Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines.

Experience working with MDAudit and Athena is a plus.

All your information will be kept confidential according to EEO guidelines.

The salary range for this role is $70,000.00 to $80,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%

and restricted

. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location

Technical Requirements (for remote workers only, not applicable for onsite/in office work):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like

Under indirect supervision, the Coding Compliance Audit Specialist conducts baseline, routine, and focused audits by comparing medical record documentation with reported CPT, HCPCS, and ICD-10-CM codes.

Successful candidates will have extensive coding audit experience, strong knowledge of CMS and Medicare guidelines, and the ability to interpret and communicate federal and state regulations while serving as an internal expert on coding compliance.

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.

Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.