ZipRecruiter

Log In

1

Radv Coding Jobs in Virginia (NOW HIRING)

All JobsRadv Coding JobsRadv Coding Jobs in Virginia

Radv Coding information

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

To thrive as a RADV (Risk Adjustment Data Validation) Coder, you need expertise in medical coding, knowledge of risk adjustment models, and familiarity with ICD-10-CM guidelines, often backed by certifications like CPC or CRC. Experience with coding software, EHR systems, and risk adjustment tools is typically required. Attention to detail, analytical thinking, and strong communication skills are vital for ensuring coding accuracy and collaborating with healthcare teams. These skills and qualifications are crucial for maintaining compliance, optimizing reimbursement, and supporting accurate healthcare data reporting.

What is a RADV Coder?

A RADV Coder, or Risk Adjustment Data Validation Coder, is a professional who reviews and validates medical records to ensure accurate diagnosis coding for risk adjustment in healthcare plans, particularly for Medicare Advantage and ACA programs. Their primary role is to confirm that submitted diagnosis codes accurately reflect patients' health conditions, supporting compliance with federal regulations. RADV Coders help healthcare organizations avoid errors in risk adjustment submissions, which can impact reimbursement and regulatory standing. They must be knowledgeable in ICD-10 coding, risk adjustment guidelines, and medical record documentation.

What are some common challenges faced by a RADV Coding professional, and how can they be effectively managed?

RADV Coding professionals often encounter challenges such as keeping up with evolving regulatory requirements, ensuring high levels of coding accuracy, and managing tight deadlines during audit cycles. Effective management of these challenges involves regular training on updated guidelines, leveraging coding tools or software to enhance efficiency, and collaborating closely with compliance and clinical teams to clarify documentation. Building strong organizational and communication skills is also key to thriving in this fast-paced environment.

What is the difference between Radv Coding vs Medical Billing Specialist?

AspectRadv CodingMedical Billing Specialist
CredentialsCertification (e.g., AAPC, AHIMA), coding credentialsBilling and coding certifications, but often less specialized
Work EnvironmentHospitals, clinics, outpatient facilitiesMedical offices, billing companies, healthcare providers
Industry UsageUsed for accurate coding for reimbursement and recordsHandles billing, claims submission, and payment processing
Search & Comparison IntentFocuses on coding accuracy and complianceFocuses on billing processes and claims management

Radv Coding primarily involves assigning accurate medical codes for radiology procedures, ensuring compliance and reimbursement. Medical Billing Specialists handle the billing process, submitting claims and managing payments. While both roles work closely within healthcare revenue cycle management, Radv Coders focus on coding accuracy, whereas Billing Specialists focus on financial transactions.

What are popular job titles related to Radv Coding jobs in Virginia? For Radv Coding jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Radv Coding jobs in Virginia look for? The top searched job categories for Radv Coding jobs in Virginia are:
Radv Coding jobs near you
Mid-Level Coder Medical Records Analyst

Mid-Level Coder Medical Records Analyst

Nextstep Technology Inc

Springfield, VA • On-site

$39.38/hr

Full-time

Posted 3 days ago

Job description

Description:

About the Company:


NextStep Technology Inc. is seeking a Medical Records Analyst. The medical records analyst is primarily responsible for review of health information. The MRA reviews the medical records for specific criteria and validation of specific code year sets submitted from selected organizations to government and commercial client. The position requires review of protected health information and must maintain strict confidentiality when addressing or referring to such records. The incumbent must have the ability to use a variety of office equipment, computer software, the ability to use sound and professional judgement, and to work independently. The candidate(s) will be hired as an employee up to 40 hours per week (flexible scheduling). This is a remote position


About the Role:


The medical records analyst is primarily responsible for review of health information.


Responsibilities:

  • Analyze protected health information (PHI) according to project-specific rules established by CMS to support coding accuracy and compliance with a 95% or higher quality standard
  • Participates in the medical record submission review and intake process
  • Assigns ICD-9/10-CM codes according to the guidelines as defined by the AMA coding guidelines.
  • Identify and discusses project related discrepancies with Team Lead(s).
  • Maintain all required coding credentials and continuing education requirements.
  • Stay current and have comprehensive understanding of coding rules, updates, and guidelines as defined by the AMA.
  • Perform other duties as assigned




Requirements:


Minimum Requirements:

  • Minimum of 3- 5 years of medical coding experience
  • Previous CMS-RADV and/or MAO plans experience
  • Current certification through AAPC as a CPC (Certified Professional Coder) or CRC (Certified Risk Adjustment Coder) OR AHIMA as a RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician) or CCS (Certified Coding Specialist)
  • Achieve a passing score on a NextStep administered coder assessment
  • Knowledge in anatomy and physiology, pathology of disease and medical terminology

Note: As part of your onboarding, an HHS-CMS background investigation will be required to ensure compliance with security standards and regulations. Foreign nationals must meet residency requirements and have proper work authorization.