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Radv Coding Jobs (NOW HIRING)

WhidbeyHealth

Coding Quality Auditor (RN)

Coupeville, WA · On-site

$95K - $133K/yr

Maintain audit readiness for external reviews (e.g., RADV, payer audits) Provider Collaboration ... Coders * Revenue cycle staff * Translate audit findings into actionable training and performance ...

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 ...

Harris Health System

Risk Adjustment Coder II

Houston, TX · On-site

$27.69 - $34.61/hr

Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and attending REGTAP calls. Stay current with coding standards, risk adjustment methodologies, and CMS ...

Harris Health System

Risk Adjustment Coder II

Houston, TX · On-site

$27.69 - $34.61/hr

Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and attending REGTAP calls. Stay current with coding standards, risk adjustment methodologies, and CMS ...

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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 Sep 8, 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 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.

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 August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $57,391 per year, or $27.6 per hour.

Coding Quality Auditor (RN)

WhidbeyHealth

Coupeville, WA • On-site

$95K - $133K/yr

Full-time

Medical, Dental, Vision, Life

Posted 25 days ago

Job description

JOB SUMMARY
The RN, Coding Quality Auditor is a highly specialized, enterprise-critical role responsible for safeguarding the accuracy, integrity, and completeness of clinical documentation and coded data across inpatient and outpatient services.
This position plays a pivotal role in revenue integrity, regulatory compliance, and risk adjustment performance, with a strong focus on Hierarchical Condition Category (HCC) capture and Risk Adjustment Factor (RAF) optimization. Through comprehensive chart audits, the incumbent ensures that all diagnoses and procedures are captured with the highest level of specificity, fully supported by clinical documentation, and aligned with CMS and payer guidelines.
Leveraging advanced expertise in Meditech Expanse and leading coding technologies, this role translates clinical documentation into compliant, optimized coding outcomes that support both fee-for-service and value-based reimbursement models.
This role serves as a critical link between clinical operations, coding, and financial performance, driving accuracy in clinical representation while maximizing compliant reimbursement.
PRINCIPLE FUNCTIONS include the following, other duties may be assigned:
Coding Quality & Risk Adjustment Auditing
  • Conduct comprehensive audits of clinical documentation and coded data to ensure accurate assignment of:
    • ICD-10-CM/PCS
    • CPT and HCPCS
    • HCC classifications
  • Validate risk adjustment accuracy, ensuring appropriate capture, abstraction, and submission of HCCs
  • Verify diagnoses meet MEAT criteria (Monitor, Evaluate, Assess, Treat)
  • Ensure coding reflects the highest level of specificity and clinical accuracy
  • Identify and correct under-coding, over-coding, and documentation gaps impacting reimbursement

Systems & Technology Expertise
  • Demonstrates advanced proficiency in Meditech Expanse EHR, including:
    • Clinical documentation navigation
    • Abstracting workflows
    • Coding review processes
  • Utilize best-in-class coding and auditing technologies, including:
    • 3M Encoder / 360 Encompass
    • Optum CAC (Computer-Assisted Coding)
    • TruCode Encoder
    • EPIC (in hybrid environments, as applicable)
  • Leverage system reporting tools to:
    • Identify coding and documentation trends
    • Monitor HCC capture and RAF performance
    • Analyze denial patterns and revenue leakage
  • Partner with IT and system analysts to optimize:
    • Coding workflows
    • System edits and automation
    • Charge capture processes

Revenue Capture & Integrity
  • Ensure complete and accurate revenue capture for both facility and professional services, including RVU optimization
  • Identify missed revenue opportunities and gaps in documentation or coding
  • Drive measurable improvements in RAF accuracy and overall financial performance through targeted audit insights and interventions
  • Collaborate with RCM teams to reduce denials and prevent revenue leakage
  • Support reconciliation between clinical documentation, coding outputs, and billed data to ensure end-to-end revenue integrity

Compliance & Regulatory Oversight
  • Ensure adherence to CMS regulations, risk adjustment guidelines, and payer-specific requirements
  • Perform pre-bill and post-bill audits across care settings
  • Identify compliance risks and develop corrective action plans
  • Maintain audit readiness for external reviews (e.g., RADV, payer audits)

Provider Collaboration & Clinical Validation
  • Partner directly with providers to:
    • Clarify diagnoses
    • Validate clinical documentation
    • Close documentation gaps
  • Serve as a trusted advisor on documentation and risk adjustment requirements
  • Deliver clear, respectful, and actionable feedback to improve documentation quality
  • Align provider documentation with compliant coding and reporting standards

Education & Continuous Improvement
  • Develop and deliver targeted education for:
    • Providers
    • Coders
    • Revenue cycle staff
  • Translate audit findings into actionable training and performance improvement initiatives
  • Ensure stakeholders remain current on:
    • Coding guideline updates
    • Risk adjustment model changes
    • Payer policy updates

Audit Analytics & Performance Monitoring
  • Track and analyze key performance indicators, including:
    • Coding accuracy rates
    • HCC capture rates
    • RAF score impact
    • Coding- and documentation-related denial trends
  • Identify root causes of performance gaps and implement sustainable improvements
  • Provide data-driven insights and reporting to RCM leadership

JOB KNOWLEDGE & QUALIFICATIONS
Education
  • Graduate of an accredited school of nursing.
  • BSN preferred.

Training and Experience
  • 5+ years of progressive coding experience across inpatient and outpatient settings
  • Advanced expertise in risk adjustment (HCC coding and RAF methodologies)
  • Demonstrated experience in coding audits, compliance, and revenue integrity
  • Proven success improving coding accuracy and reimbursement outcomes
  • Experience collaborating with providers and clinical teams

Core Competencies
  • Advanced knowledge of risk adjustment models and reimbursement methodologies
  • Deep understanding of Meditech Expanse and EHR-driven workflows impacting coding and revenue
  • Ability to integrate clinical documentation, coding standards, and system functionality
  • Strong analytical, problem-solving, and data interpretation skills
  • Exceptional communication skills with ability to translate complex concepts clearly
  • High attention to detail and commitment to compliance and integrity
  • Collaborative, solutions-oriented mindset

Preferred Attributes
  • Experience supporting Medicare Advantage and other major payer programs, including value-based care models, with strong understanding of risk-adjusted reimbursement, HCC coding, and RAF optimization
  • Background in denial prevention and appeals related to coding/documentation
  • Familiarity with Clinical Documentation Integrity (CDI) programs
  • Ability to influence provider engagement through education and data

Certificates, Licenses, Registrations
  • Active WA State RN License or Active Multistate License (MSL)
  • MSL Requirements:
    • Approved 6-Hour Suicide Prevention Training Course Completion
    • Screenshot of submitted demographic data using the Washington State Multistate Nurse Demographic Data Survey.
  • Required certification (one or more):
    • CCS, CPC, CRC, RHIT, or RHIA
    • CRC strongly preferred (risk adjustment focus)

Health & Well-Being You Can Count On
We offer a thoughtful, comprehensive benefits package designed to support you and your family at every stage of life:
  • Medical Coverage - HDHP w/HSA / PPO
  • Prescription Drug Coverage
  • Dental Options - PPO / Managed-Care Plan
  • Vision Benefits - VSP
  • Life & AD&D Insurance - Employer paid coverage
  • Long-Term Disability Coverage - Employer paid income Protection
  • Health Savings Account (HSA) - If enrolled in HDHP
  • Healthcare Flexible Spending Account (FSA) - Dependent & Healthcare
  • Employee & Provider Assistance Programs - Free, confidential support
  • Voluntary Life & AD&D Insurance - Additional employee paid buy up option
  • Voluntary Long-Term Disability Coverage - Additional employee paid buy up option

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