Coding Compliance Specialist

A company is looking for a Coding Compliance Specialist responsible for overseeing and evaluating Risk Adjustment Data Validation medical record review work.

Key Responsibilities

Ensure adherence to CMS RADV payment and risk adjustment policies

Provide expert guidance on coding and documentation standards

Review escalated Medicare RADV medical record cases and resolve complex issues

Required Qualifications

RADV experience required

Minimum 5 years of supervisory experience in medical record review, preferably RADV

Proven expertise in reviewing escalated Medicare RADV medical record cases

Medical Coding Certification from an accredited entity (e.g., AAPC, AHIMA)

Advanced knowledge of coding systems and compliance regulations