Sr. Clinical Coder (CPC, CRC Certification Required)

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

Travel Required: 30%

The Sr. Clinical Coder is responsible for supporting the growth and improvement of Privia Health’s value-based care capabilities, by conducting training, education, and management of ACO tactics. 

The ideal candidate is knowledgeable in coding and documentation guidelines, knows how to develop strong relationships with clinicians, and is an effective, strong communicator. Successful candidates will also have extensive presentation experience in the following areas: ICD-10-CM, CPT and HCPCS. 

Primary Job Duties:

• Collaborate with the Clinical Performance Committee and Physician Leaders to meet performance targets. 

• Develop action plans to regions and POD to improve overall performance in the ACO

• Support the onboarding and training of providers to ensure success in risk bearing programs. 

• Collaborate with internal teams on Quality, HCC Documentation & Coding, Clinical Operations and Performance Management. 

• Using primarily the Hierarchical Condition Category (HCC) Risk Adjustment model, conduct training with individual and large provider groups, predominately in-person. 

• Execute on risk adjustment onboarding training plans with new providers in the market. 

• Train on effective EHR workflows to support coding and documentation for both known and suspected conditions. Expert in how providers document and code in the EHR clinical record; serve as level one support for basic EHR customer support questions specific to risk adjustment workflows. 

• Providers on and off-site support to healthcare providers, front/back office and administrative staff, including, but not limited to: providing education and training to providers and staff; developing and maintaining resource materials, guides and process workflows; mining, scanning and uploading patient medical documents from EMRs; and patient outreach. 

Qualifications

• Certified Professional Coder (CPC) required; and  (CRC) Certified Risk Adjustment Code preferred

• 5+  experience with coding and documentation. 

• Federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding compliance

• Extensive knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codes. 

• MS Office Suite, EMRs, Encoder, Coding Clinic, G-Suite, and other programs and internet based applications as needed to fulfill position duties. 

• A valid unrestricted drivers’ license and reliable vehicle

• Maintain patient, team member and employer confidentiality; comply with all HIPAA regulations. 

The salary range for this role is $58,500.00 to $78,000.00 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus targeted at 15% and restricted stock units 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 of 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.