Jobs at Privia Health

Audit payer-processed claims and care center payments to ensure reimbursement accuracy, conduct post-implementation audits, track/report outcomes, resolve payment variances with payers and internal teams, support Trizetto/Cognizant and fee schedule setups, manage denial trends, and assist revenue cycle teams to maximize cash flow.

Lead and mentor a Salesforce engineering delivery team to design, build, test, and deploy scalable Salesforce solutions. Drive Agile/DevOps processes, release governance, and SLA accountability. Collaborate on platform architecture, integrations, AI readiness, data modeling, and HIPAA-compliant security. Optimize tools, AppExchange integrations, and roadmap alignment with product and operations.

Lead development and delivery of advanced coding education for providers and groups, design specialty-specific training, analyze coding performance, schedule and coordinate sessions, resolve coding compliance inquiries, and maintain up-to-date training materials and documentation to improve coding accuracy and regulatory compliance.

Deliver risk-adjustment and coding education (HCC, ICD-10-CM, CPT, HCPCS), conduct prospective and retrospective chart audits, analyze coding performance, generate audit reports, lead provider trainings, ensure CMS/AMA compliance, and support documentation improvement initiatives.

Audit medical records for coding compliance (CPT, ICD-10, HCPCS), prepare audit reports, provide provider education and training, interpret federal/state CMS/Medicare regulations, and support coding issue resolution and documentation improvement.

Design, develop, and maintain Salesforce solutions including LWC/LWR UI, legacy Aura support, AI features (Einstein/Agentforce), event-driven integrations, Copado CI/CD, advanced Flows, and data/backup management while providing technical support and stakeholder documentation.

Manage payer enrollment for New Jersey providers and care centers: submit enrollments to commercial and federal payers, maintain payer data in CredentialStream, resolve claims and enrollment issues via AthenaOne and Salesforce, coordinate onboarding with internal teams, and ensure HIPAA compliance.

The Coding Compliance Audit & Education Specialist audits medical records for compliance, educates providers on coding guidelines, and prepares audit reports. They conduct trainings, communicate findings, and provide consultation to ensure compliance with federal regulations.