Coding Compliance Specialist

• Candidate must have direct experience working on the Centers for Medicare & Medicaid Services Risk Adjustment Data Validation (CMS RADV) contract.
• Day time availability is required due to meetings.

Position Summary

TheCoding ComplianceSpecialist is responsible for overseeing and evaluating assigned Risk Adjustment Data Validation (RADV) medical record review (MRR) work performed under the contract. This role ensures compliance with CMS RADV guidelines, coding standards, and risk adjustment policies while maintaining the highest quality and accuracy in medical record documentation. This is a part-time, remote position with flexible scheduling, ideal for experienced professionals seeking autonomy and work-life balance.

Key Responsibilities

• Ensure adherence to CMS RADV payment and risk adjustment policies.
• Provide expert guidance on coding and documentation standards, including ICD-CM, HCC, and Risk Adju...

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