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Radv Audit Jobs (NOW HIRING)

Careers Integrated Resources Inc

Medical Coder III

$27/hr

CMS RADV Medical Reviewer Guidance (1/10/2020). Top Skills Required: Must have prior experience with CMS Contract Level Risk Adjustment Data Validation Audits (RADV) and HHS RADV audits and IPM ...

New

Aquity Solutions

Director Risk Adjustment - Remote

$130K - $150K/yr

... RADV audit readiness. * Product & Technology Collaboration: Partner cross-functionally with the Product team as the primary business stakeholder representing coding, auditing, and regulatory best ...

US Tech Solutions

Medical Billing Coder

Wellesley, MA · Remote

$20.50 - $27.50/hr

... RADV) Audits. This role will also assist with building the medical chart review program at Client's Duties and Responsibilities * Utilize comprehensive knowledge American Hospital Association (AHA ...

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · On-site

$27 - $30.75/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · Remote

$30 - $35/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

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How much do radv audit jobs pay per year?

As of Aug 17, 2026, the average yearly pay for radv audit in the United States is $71,776.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,500.00 and $81,500.00 per year, depending on experience, location, and employer.

What are some common challenges faced by professionals in a RADV audit role, and how can they be addressed?

Professionals in a Radv Audit role often encounter challenges such as managing tight deadlines, navigating complex regulatory requirements, and ensuring accuracy in documentation. Collaborating closely with cross-functional teams and maintaining clear communication with stakeholders can help mitigate misunderstandings and streamline the audit process. Staying updated with current industry standards and leveraging audit management tools are also crucial for maintaining efficiency and compliance. Proactively seeking feedback and participating in continuous learning opportunities can further enhance performance in this role.

What is a RADV audit?

A RADV (Risk Adjustment Data Validation) Audit is a process used by the Centers for Medicare & Medicaid Services (CMS) to verify the accuracy of diagnosis codes submitted by Medicare Advantage organizations. The purpose is to ensure that health plans are being compensated appropriately based on the health status of their members. During a RADV audit, patient medical records are reviewed to confirm that the diagnoses used for risk adjustment are supported by documentation. This helps prevent overpayments and ensures compliance with federal regulations. Organizations found to have unsupported diagnoses may be required to repay funds to CMS.

What is the difference between Radv Audit vs Radv Analyst?

AspectRadv AuditRadv Analyst
CertificationsCPA, CIA, CISACPA, CIA, CISA
Work EnvironmentAudit firms, corporate audit departmentsFinancial institutions, consulting firms
Primary FocusEvaluating internal controls, compliance, and financial accuracyAnalyzing risk, data, and financial reports to support audits

Radv Auditors primarily focus on evaluating internal controls and ensuring compliance through audits, while Radv Analysts analyze data and risks to support audit processes. Both roles require similar certifications and often work in related environments, but their core responsibilities differ in scope and focus.

What key skills and qualifications are needed to thrive as a RADV auditor, and why are they important?

To excel as a RADV (Risk Adjustment Data Validation) Auditor, you need a solid understanding of medical coding, healthcare regulations, and risk adjustment methodologies, typically supported by credentials like CPC, CRC, or RHIA. Familiarity with audit software, electronic health records (EHRs), and CMS guidelines is essential. Strong analytical thinking, attention to detail, and effective communication are important soft skills for interpreting data and conveying findings. These skills ensure accurate validation of medical records, compliance with regulatory standards, and the integrity of healthcare reimbursement processes.
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Radv Audit jobs near you
Infographic showing various Radv Audit job openings in the United States as of August 2026, with employment types broken down into 80% Full Time, and 20% Contract. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $71,776 per year, or $34.5 per hour.

Director - Coding, Audit, Compliance & Operational Excellence

VMG Health

Dallas, TX • On-site

Full-time

Re-posted 2 days ago

Job description

Description:

VMG Health supports a nationwide network of clients with over 70,000 engagements, exclusively in the healthcare industry. Our national client base ranges from large health systems to small practices and everything in between, including investors and private equity firms. VMG Health provides a solutions-oriented approach to client needs through our strong market position, extensive contacts, unparalleled tools and solutions, and expert insights. We are proud to serve as the single source for all our clients’ valuation, strategic, and compliance needs.

Requirements:

We are seeking an experienced Director to support the continued growth of our Coding, Audit, Compliance, and Revenue Cycle Management (RCM) consulting practice. This role will provide strategic leadership across client engagements, with a particular focus on coding compliance, revenue cycle operations, and risk adjustment (RADV/HCC).


The Director will play a key role in designing and delivering provider-focused education and training programs across multiple specialties, supporting documentation improvement, coding accuracy, and overall compliance.


This individual will lead complex engagements, guide high-performing teams, and partner with clients to develop actionable, compliant, and operationally effective solutions. This is a highly visible, client-facing role with opportunities to contribute to service line innovation and business development.

Key Responsibilities

Client Engagement & Leadership

  • Provide strategic oversight for coding, audit, compliance, and revenue cycle engagements
  • Serve as a trusted advisor to clients, delivering clear, actionable recommendations
  • Ensure delivery of accurate, high-quality, and audit-defensible work products
  • Lead executive-level presentations and client discussions

Revenue Cycle & Risk Adjustment Expertise

  • Lead and advise on RCM initiatives, including coding, billing, audit, and revenue integrity
  • Oversee RADV/HCC audits and documentation improvement strategies
  • Evaluate provider documentation and coding accuracy to ensure compliance with CMS and payer requirements
  • Identify opportunities to improve reimbursement, risk capture, and operational performance

Team Leadership & Development

  • Mentor and develop Managers, Auditors, and consulting staff
  • Provide guidance on engagement execution, quality standards, and client communication
  • Foster a collaborative, high-performing team environment

Business Development

  • Develop and maintain client relationships to support growth
  • Identify and pursue new business opportunities
  • Participate in proposals, presentations, and industry events
  • Contribute to thought leadership, including publications and speaking engagements



Qualifications

Experience

  • 8+ years of healthcare industry experience
  • Proven experience in Revenue Cycle Management (RCM) and healthcare operations
  • Demonstrated expertise in HCC/risk adjustment coding and documentation

Technical Expertise

  • Strong knowledge of:
    • ICD-10-CM, CPT®, and HCPCS coding
    • E/M documentation guidelines
    • CMS regulations and payer requirements
    • Revenue cycle processes (coding, billing, denials, reconciliation)

Credentials

  • CPC, CPMA, CRC required
  • Bachelor’s degree preferred

Skills & Competencies

  • Strong analytical and problem-solving abilities
  • Excellent written and verbal communication skills
  • Executive presence and client-facing experience
  • Ability to manage multiple complex projects simultaneously
  • Detail-oriented with a strong focus on quality and compliance

Apply