Senior Medical Coder - RADV/CMS Audit Specialist

Paycom - ATS; Milford Mill (MD); On-site; USD 60,000 - 65,000; Full time

Job summary

RELI Group in Windsor Mill, MD is seeking a RADV medical coder to perform intake and coding validation of medical records and enter data into CMS tools, in accordance with contract and organizational guidelines.

The role supports the Project Director, responds to coder questions, and ensures 95% minimum IRR, while safeguarding PHI and complying with security standards. Five+ years of hospital/integrated coding experience and active coder credentials are preferred.

Qualifications

• Experience coding general acute hospital (inpatient/outpatient) and/or multi-specialty physician office medical records.
• Must be a certified coder credentialed by a recognized credentialing institution.
• Five+ years of experience in coding and related RADV audits preferred.

Responsibilities

• Perform RADV-compliant diagnosis coding for inpatient, outpatient, and physician office records.
• Evaluate intake validity, attestations, non-compliance issues, and other validations per RADV guidelines.
• Conduct Medical Record Disputes and Appeals reviews with technical writing per RADV guidelines.
• Provide Appeals support as RADV Subject Matter Expert at CMS requests.
• Participate in QA Panel discussions for medical record review intake/coding and appeals.
• Interact with physician reviewers as required.
• Enter data into encoder, CDAT-M, and other required software using a computer.
• Maintain security and confidentiality of PHI.
• Meet productivity and accuracy standards (IRR) of 95% minimum.

Skills

Independent worker

Concentration

Attention to detail

Professional communication

Team collaboration

Confidentiality

Education

High School diploma

Certified medical coder

Tools

Microsoft Office Suite

Encoder/CDAT-M

Job description

RELI Group in Windsor Mill, MD is seeking a RADV medical coder to perform intake and coding validation of medical records and enter data into CMS tools, in accordance with contract and organizational guidelines.

The role supports the Project Director, responds to coder questions, and ensures 95% minimum IRR, while safeguarding PHI and complying with security standards. Five+ years of hospital/integrated coding experience and active coder credentials are preferred.