Senior RADV Coding Auditor - Medicare Advantage Expert

Zing Health, Inc.; Northern (KY); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Medical, Dental, and Vision

Employer-Paid Life Insurance

Paid Maternal Leave

Paid Paternal Leave

401K match up to 4%

Paid Time-Off

Employee Assistance Programs

Supplemental benefits

Job summary

Zing Health seeks a Senior Risk Adjustment Coding Auditor to ensure accurate, compliant risk adjustment coding across Medicare Advantage programs. You will play a key role in RADV audits, vendor quality oversight, and regulatory compliance while driving continuous improvement.

The ideal candidate has deep Medicare Advantage expertise, strong project management skills, and a passion for coding excellence within a fast-paced, evolving environment.

Qualifications

• Active coding certification required; CRC strongly preferred.
• Minimum of 5 years of Medicare Advantage Risk Adjustment coding and auditing experience.
• Advanced knowledge of CMS-HCC risk adjustment methodology, ICD-10-CM, Medicare Advantage regulations, and RADV requirements.
• Experience auditing coding vendors, in-home assessment programs, and risk adjustment submissions; QA and validation.
• Strong analytical, problem-solving, organizational, and communication skills.

Responsibilities

• Review, validate, and code Medicare Advantage records using ICD-10-CM and CMS-HCC methodologies.
• Conduct quality assurance audits for coding accuracy and documentation integrity.
• Support RADV audits and other regulatory reviews with chart review and audit readiness.
• Monitor coding quality and vendor performance to identify gaps and improvement opportunities.
• Lead quality improvement initiatives with vendors and cross-functional teams; provide recommendations to leadership.
• Provide SME guidance on ICD-10-CM, CMS-HCC, RADV requirements, and CMS guidance.
• Leverage analytics and digital tools to improve coding accuracy and audit effectiveness.

Skills

Medicare Advantage risk adjustment

Active coding certification

Excel

Audit reporting tools

Analytical skills

Education

Bachelor’s degree in Health Information Management or Nursing

Tools

Microsoft Excel

Coding platforms

Job description

Zing Health seeks a Senior Risk Adjustment Coding Auditor to ensure accurate, compliant risk adjustment coding across Medicare Advantage programs. You will play a key role in RADV audits, vendor quality oversight, and regulatory compliance while driving continuous improvement.

The ideal candidate has deep Medicare Advantage expertise, strong project management skills, and a passion for coding excellence within a fast-paced, evolving environment.