Judge Group

Compensation

Full Description

Location: REMOTE Salary: $22.00 USD Hourly - $23.00 USD Hourly Description: RADV Business Operations Specialist (Medical Records Outreach & Audit) Location: Remote Start Date: August 25, 2025 Hourly Rate: $23/hour Contract Type: Temporary (August 2025-February 2026)Schedule: • Training: Monday–Friday, 8:00 AM–5:00 PM PST • Post-Training Shift Start Times: (Monday-Friday, 40 hours/week) • 6:00 AM–8:00 AM PST • 7:00 AM MST • 8:00 AM CST • 9:00 AM EST Role Overview: The RADV Business Operations Specialist plays a critical role in the CMS Risk Adjustment Data Validation (RADV) audit process. This position focuses on provider outreach, record retrieval, quality assurance, and medical record submission to support compliance with client and CMS service level agreements (SLAs). Key Responsibilities: • Conduct outreach to providers and facilities that have been unresponsive or declined participation, to obtain necessary medical records within defined program timeframes. • Create and assemble RADV submission packets for providers. • Intake, organize, and audit medical record images before forwarding for coding. • Perform quality assurance checks on medical records to ensure completeness and compliance. • Upload audited records and documentation to the CMS submission portal, per member and HCC (Hierarchical Condition Category). • Monitor and resolve issues related to Provider Non-Participation (PNP) in the RADV audit process. Skills & Qualifications: • Experience in medical records handling, coding & billing, healthcare operations, or audit support preferred. • Strong attention to detail and organizational skills. • Comfortable working within set timeframes and managing compliance-related documentation. • Excellent communication skills for provider outreach and issue resolution. • Ability to work independently with minimal supervision, especially during early shift hours. By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help. Contact: jmaybrier@judge.com This job and many more are available through The Judge Group. Find us on the web at www.judge.com Remote Skills: Auditing, Centers for Medicare and Medicaid Services (CMS), Communication Skills, Content Management Systems (CMS), Contract Management, Data Management, Detail Oriented, Establish Priorities, Medical Imaging, Medical Records, Multiplatform/Cross-Platform, Multitasking, Organizational Skills, Quality Assurance, Service Level Agreement (SLA), Short Messaging Service (SMS), Time Management About the Company: Judge Group The Judge Group Inc., is a leading professional services firm specializing in talent, technology, and learning solutions. We consult, staff, train, and solve. Through our work we make people and organizations better. Our services are successfully delivered through a network of more than 30 offices across the United States, Canada, and India. The Judge Group is proud to partner with the best and brightest companies in business today, including over 60 of the Fortune 100. We serve organizations in financial services, healthcare, life sciences, insurance, government (including aerospace and defense), manufacturing, and technology and telecommunications. If you would like to learn more about The Judge Group visit www.judge.com or call toll free (800) 360-4474. Company Size: 5,000 to 9,999 employees Industry: Computer/IT Services Founded: 1970 Website: https://www.judge.com