ProFee Provider Coding Educator

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 Educator will be accountable for provider satisfaction related to CODER+ services provided by Privia Health. The Educator will serve as an integral member of the CODER+ program team, responsible for partnering with providers and staff to ensure smooth delivery of CODER+ surgical services and to maintain provider satisfaction. This person will collaborate with the Providers, CODER+ Program Manager and Clinic Managers as needed to resolve any CODER+ issues that may arise. The ideal candidate will draw on existing expertise in surgical specialty medical coding, provider education, billing and compliance with government and commercial payers and act as a coding resource for Providers to reach out to. The ideal candidate is a self-starter, comfortable with managing multiple priorities, and a creative problem solver.

Primary Job Duties:

• Conduct provider/clinical staff documentation reviews as requested identifying opportunities for improvement
• Create education material and/or hold educational sessions either virtually, or in person, as requested
• Apply appropriate coding classification standards and guidelines to medical record documentation for accurate coding
• Perform quality reviews of records, including verification of medical record documentation (electronic and handwritten)
• Perform reviews of coders completed work to validate standards are met as requested
• Research and answer coding and coding workflow related questions for providers and clinic staff
• Educate coders and other staff on appropriate coding guidelines
• Assist in development and ongoing maintenance of processes and procedures for each assigned client
• Collaborate with internal Privia+ and Privia teams
• Collaborate with vendor partners
• Follow coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
• Assist in the Privia+ day-to-day coding/educational needs as needed
• Other duties as assigned

Qualifications

• 5+ years of provider medical coding experience across various specialties in the ProFee space
• OB-GYN coding experience preferred
• AAPC Certified Professional Coder (CPC) and/or Certified Professional Medical Auditor (CPMA) certification highly preferred
• Experience working in a physician practice setting strongly preferred
• Ability to work effectively with physicians, non-physician practitioners (NPP), practice staff, health plan/other external parties, coding and billing vendors, as well as both Privia+ and Privia teams
• Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes
• Must comply with HIPAA rules and regulations
• Able to have honest, difficult conversations with providers and office managers
• Passion for efficiency and a drive to reduce redundancy and waste
• Ability to work in a fast-paced environment with all levels of management
• Able to work through periods of ambiguity
• Excellent oral and written communication skills
• Knack for prioritizing efficiently and multi-tasking
• Self-directed with the ability to take initiative
• Competent in maintaining confidential information
• Enthusiastic with the ability to thrive in an atmosphere of constant change
• Travel on occasion as needed to support business needs

The salary range for this role is $75,000 to $80,000 in base pay and exclusive of any bonus 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% 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.

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.