Coding Compliance Audit Associate

Company Description

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.

Job Description

The Coding Compliance Audit Associate is responsible for supporting the audit process by maintaining accurate records and tracking data for providers and care centers. This role involves managing audit schedules, monitoring the completion of necessary training, and coordinating the assignment of audits to auditors. The role requires strong organizational skills, attention to detail, and effective communication to support smooth audit operations.

• Maintain accurate records by updating the provider audit and education tracker with new providers/care centers.
• Monitor and track the completion of education pre- and post-audit to begin audits.
• Create and assign audits to auditors based on the audit schedule and availability
• Map and update new facilities and providers, regularly review provider mappings in MD Audit software, and update as necessary.
• Manually upload claims for initial and follow-up audits when necessary.
• Request medical records if needed for audits.
• Sends audit results reports to the appropriate stakeholders.
• Monitors the coding questions Monday Board and assigns them to the appropriate auditor.
• Other duties as assigned

Qualifications

• Minimum 4 years of experience in coding compliance audit support functions.  
• Basic knowledge of ICD-10, CPT, and HCPCS coding.
• Basic understanding of healthcare regulations and guidelines (e.g., CMS, OIG)
• EHR experience required
• Strong organizational and data entry skills.
• Attention to detail with a focus on accuracy and compliance.
• Good communication skills, both written and verbal.
• Ability to multitask and handle shifting priorities in a fast-paced environment.

The salary range for this role is $46.000 to $58,000 in base pay. This role is also eligible for an annual bonus targeted at 10% based on performance in the role. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Additional Information

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

Preferred experience with profession-based telephonic or remote communication ● Must comply with all HIPAA rules and regulations 

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 https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.