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 Senior Coding Compliance Educator is a subject matter expert responsible for the development and delivery of comprehensive coding education and providing advanced consultation to Privia Providers and staff. Successful candidate will have extensive expertise in CPT, ICD-10-CM, and HCPCS coding and demonstrate a proven track record in delivering high-impact training to diverse provider groups. This role is pivotal in enhancing our provider education programs and improving coding accuracy and compliance across our rapidly growing organization. Lead advanced coding education for both individual providers and large provider groups, utilizing remote methods. Topics include but are not limited to Evaluation & Management (E/M), Medicare Preventive services, and Office Procedures) Design, implement, and lead specialty-specific documentation and coding training programs to address unique needs and challenges. Analyze key coding performance indicators to determine those providers in need of initial or additional E/M training. Strategically schedule and coordinate training sessions with provider offices, individual providers, and groups, ensuring alignment with organizational priorities and provider needs. Lead initiatives to identify and address relevant documentation and coding projects, contributing to the ongoing enhancement of training resources and tools. Develop and refine coding presentations and educational materials, ensuring they reflect the latest industry standards and regulatory requirements. Proactively identify and prioritize training needs, scheduling sessions to address gaps and improve overall provider performance. Monitor and address market trends and emerging issues related to documentation and coding, ensuring timely and relevant updates to training programs. Resolve coding compliance inquiries, ensuring all responses are researched, documented, and delivered within established service level agreements (SLAs). Perform additional related duties as assigned, contributing to the overall success and growth of the Coding Compliance Education team.

Qualifications

Certification as a Professional Coder (CPC) 7+ years of experience in coding CPT, ICD-10, and HCPCS, with a strong background in developing and leading provider training sessions. In-depth knowledge of AMA CPT and CMS ICD-10 coding and reporting guidelines. Extensive understanding of documentation and coding guidelines set forth by CMS and AMA for diagnostic and procedural code assignment. Proficient in Google Office Suite, Electronic Medical Records, Monday, Codify, and other relevant software applications. Experience with Customer Relationship Management (CRM) tools such as Salesforce Experience navigating EHRs Demonstrated ability to maintain confidentiality and comply with HIPAA regulations. Proven ability to engage in honest and challenging conversations with providers regarding documentation and code assignment. Exceptional communication skills, with the ability to convey complex information clearly and effectively to diverse audiences. Composed and resilient in high-pressure situations, demonstrating maturity and professionalism. Strong time management and organizational skills, with a capacity to manage multiple priorities efficiently. Excellent presentation skills, with experience leading training sessions for large groups of physicians and executives. Ability to build and maintain effective relationships with physicians, non-physician practitioners (NPP), practice staff, and external parties. Positive attitude towards work, clients, management, and team members, with a customer-focused approach to conflict resolution and problem-solving. The salary range for this role is $70,000.00 to $82,500.00 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%. 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. 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. We understand that healthcare is local and we are better 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. Department: Audit & Coding