ZipRecruiter

Log In

1

Radv Coding Jobs in Virginia (NOW HIRING)

DaMar Staffing

Risk Adjustment Coder

Virginia Beach, VA · On-site

$100 - $125/hr

Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. * Conducts annual risk ...

Sentara Health

Risk Adjustment Coder

Virginia Beach, VA · Hybrid

$10K/mo

Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk ...

All JobsRadv Coding JobsRadv Coding Jobs in Virginia

Radv Coding information

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 skills and qualifications are needed to thrive as a RADV coder?

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 are common challenges faced by a RADV coder, and how can they be 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

Risk Adjustment Coder

Sentara Healthcare Inc

Virginia Beach, VA • On-site

$60 - $80/hr

Other

Posted 6 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

496th of 898 rated healthcare providers

Job description

Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!

Hours: Monday - Friday, 8:00AM -5:00PM, dayshift.

This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration.

Overview

Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs vendor quality oversight audits; reviews and/or makes final coding determination for non-agreeable coding. Makes final decision on vendor-to-vendor diagnosis coding rebuttal concerns. Serves as subject matter expert on risk adjustment diagnosis coding guidelines. Coordinates risk adjustment gap elimination with clinical and quality gap elimination Maintains a reasonable fluency in workings & financial implications of applicable risk adjustment models.

Education
  • Associate degree (Required)
Experience
  • Medical Records Data - 1 year (Required)
  • Coding - 2 years (Required)
Certifications:

One of the following certifications are required: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist-Physician-based (CCS-P), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).

Must obtain Certified Risk Adjustment Coder (CRC) certification within two years of employment.

Keywords:

Risk Adjustment Coding & Documentation Specialist, Talroo-Allied Health, Medical Office

#J-18808-Ljbffr

What Sentara Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply