Coding Compliance Audit – Education Specialist

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $70k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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Privia Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

💳 Fintech

💰 $450M Post-IPO Equity on 2021-04

Healthcare • Fintech

Privia Health is a national physician platform transforming the healthcare delivery experience. They provide tailored solutions for physicians and providers, creating value and securing their future. Through high-performance physician groups, accountable care organizations, and population health management programs, Privia collaborates with health plans, health systems, and employers to better align reimbursements to quality and outcomes.

📋 Description

• Audit medical records for compliance with federal coding regulations and guidelines • Conduct baseline, routine periodic, and focused audits comparing documentation with CPT/HCPCS and ICD-10-CM codes • Research, interpret, and communicate federal and state laws and CMS/Medicare guidelines • Act as an internal expert on coding compliance issues • Prepare audit reports, including summaries of findings • Conduct post-audit provider education for individual providers and large provider groups • Schedule trainings with provider offices and providers • Provide feedback, education, training, and technical support on documentation, service selection, charge capture, supervision, timely submission, healthcare data accuracy, and coding principles • Communicate audit findings to providers and track education completion and escalation • Provide coding assessment, consultation, education, and issue resolution to stakeholders • Discuss compliance, documentation, and code assignment issues with providers • Perform other duties as assigned

🎯 Requirements

• 5+ years of audit and provider education experience is preferred • Extensive knowledge of CPT, ICD-10, and HCPCS codes and guidelines • Certified Professional Coder (CPC) required • Certified Professional Medical Auditor (CPMA) preferred • Experience working with MDAudit and Athena is a plus • Must comply with all HIPAA rules and regulations • Excellent communication skills • Ability to work independently • Minimum remote-work internet speed of 5 MBPS download and 3 MBPS upload • Ability to work remotely from the United States

🏖️ Benefits

• Annual bonus targeted at 15% • Medical insurance • Dental insurance • Vision insurance • Life insurance • Pet insurance • 401K • Paid time off • Wellness programs • Remote work • Expense reimbursement for employees who regularly work from home offices • EEO-protected work environment

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