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Radv Coding Jobs (NOW HIRING)

EmblemHealth

Lead Audit Specialist - Remote

New York, NY · On-site +1

$77K - $149K/yr

Develop and refine RADV audit strategies, including improvements in medical record retrieval processes and reducing coding errors; manage efforts to enhance RADV audit coordination workflows.

RELI GROUP INC

Senior Medical Coder

Baltimore, MD · On-site

Provide Appeals support as RADV Subject Matter Expert at CMS request * Participate and contribute to QA Panel discussions for medical record review intake/coding and appeals, as needed. * Interact ...

Mass Advantage

Manager, Risk Adjustment

Worcester, MA · On-site

Maintain a comprehensive QA program covering RADV, OIG, and internal audits - monitoring the work of internal coders, contracted vendors, and provider documentation alike. * Own encounter data ...

RELI GROUP INC

Senior Medical Coder

Baltimore, MD

Provide Appeals support as RADV Subject Matter Expert at CMS request * Participate and contribute to QA Panel discussions for medical record review intake/coding and appeals, as needed. * Interact ...

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Radv Coding information

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$29K

$57.4K

$80.5K

How much do radv coding jobs pay per year?

As of Jun 4, 2026, the average yearly pay for radv coding in the United States is $57,391.00, according to ZipRecruiter salary data. Most workers in this role earn between $46,000.00 and $66,500.00 per year, depending on experience, location, and employer.

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 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 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 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.

More about Radv Coding jobs
What cities are hiring for Radv Coding jobs? Cities with the most Radv Coding job openings:
What states have the most Radv Coding jobs? States with the most job openings for Radv Coding jobs include:
What job categories do people searching Radv Coding jobs look for? The top searched job categories for Radv Coding jobs are:
Radv Coding jobs near you
Infographic showing various Radv Coding job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 50% In-person, and 50% Remote job distribution, with an average salary of $57,391 per year, or $27.6 per hour.
Risk Adjustment Coding Auditor

Risk Adjustment Coding Auditor

Blue Cross and Blue Shield of Minnesota

Eagan, MN • Remote

$31.48 - $39.35/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

Blue Cross Blue Shield Of Minnesota rating

5.3

Company rating: 5.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

249th of 260 rated insurance

Job description

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

Blue Cross and Blue Shield of Minnesota is hiring a Risk Adjustment Coding Auditor. The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise.

An ideal candidate has 5+ years of risk adjustment coding experience and an active CRC certification. This is a production-based role requiring comfort in a high-volume environment.

Your Responsibilities

  • Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices
  • Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements
  • Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting
  • Verifies and ensures the accuracy, completeness, specificity and appropriateness of providerreported diagnosis codes based on medical record documentation
  • Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories
  • Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements
  • Contributes to audit and production efforts to meet business demand and workload priorities
  • Provide written and verbal guidance on coding errors to others
  • Meets audit deliverables within established timelines and deadlines
  • Assists with special projects such as risk mitigation reviews
  • Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment

Required skills and experiences:

  • 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
  • 5+ years of HCC coding experience in utilizing inpatient and outpatient coding guidelines
  • 5+ years of experience auditing Risk Adjustment records
  • 1+ years working in a Production environment
  • CRC (Certified Risk Coder) in good standing, in addition to required coding certification or ability to obtain certification within the first 6 months of hire.
  • Intermediate level of knowledge in risk adjustment Medicare, ACA Commercial and Medicaid models
  • Demonstrated ability to apply critical thinking skills to coding policy interpretation and implementation.
  • Experience providing written and verbal guidance on coding errors and trends
  • Intermediate (or higher) MS Office (Word, Excel, Powerpoint & Outlook)
  • Excellent organizational ability to manage multiple projects and perform in a deadline driven environment
  • High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred skills and experiences

  • Bachelor's degree
  • HEDIS/STARS experience
  • Provider education experience
  • Prior RADV experience
  • CPMA or other coding credentials
Role DesignationTeleworker

Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite.

Compensation and Benefits$31.48 - $39.35 - $47.22 Hourly

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

  • Medical, dental, and vision insurance

  • Life insurance

  • 401k

  • Paid Time Off (PTO)

  • Volunteer Paid Time Off (VPTO)

  • And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

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