Coding Compliance Audit & Education Specialist

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)