RADV Compliance Lead — Remote, Part-Time

J29, Inc.; Millersville (MD); Remote; USD 60,000 - 90,000; Part time

Job summary

A healthcare compliance organization is seeking a part-time Coding Compliance Specialist to oversee and evaluate RADV medical record reviews. The ideal candidate will have extensive experience with CMS RADV contracts, strong analytical skills, and a commitment to compliance. Responsibilities include ensuring adherence to guidelines, conducting training, and providing expert coding guidance. This remote role offers flexible scheduling, making it ideal for experienced professionals looking for autonomy and work-life balance.

Qualifications

• Minimum 5 years of supervisory experience in medical record review, preferably RADV.
• Proven expertise in reviewing escalated Medicare RADV medical record cases.
• In-depth knowledge of RADV processes and payment policies.

Responsibilities

• Ensure adherence to CMS RADV payment and risk adjustment policies.
• Review escalated Medicare RADV medical record cases and resolve complex issues.
• Conduct medical record, coding, and policy research.

Skills

Expert guidance on coding and documentation standards

Quality assurance and compliance

Medical record analysis

Training program development

Strong analytical and problem-solving skills

Education

Medical Coding Certification from an accredited entity

RHIT, RHIA, CCS, CPC, CRC

Job description

A healthcare compliance organization is seeking a part-time Coding Compliance Specialist to oversee and evaluate RADV medical record reviews. The ideal candidate will have extensive experience with CMS RADV contracts, strong analytical skills, and a commitment to compliance. Responsibilities include ensuring adherence to guidelines, conducting training, and providing expert coding guidance. This remote role offers flexible scheduling, making it ideal for experienced professionals looking for autonomy and work-life balance.