Remote RADV Operations Analyst

Remote RADV Operations Analyst Staff Augmentation Minnetonka , Minnesota Contract Do you want to work for a company that Forbes named one of the Top 50 Most Innovative Companies? Are you looking to fast-track your career with one of LinkedIn's top companies in the U.S.? If so, keep reading!

Title of Job:

Remote RADV Operations Analyst

Location:

REMOTE (anywhere in the US, Minnesota preferred) CSI Companies is hiring a Remote RADV Operations Analyst for our Fortune 100 healthcare client in Minnetonka, MN. This job can be worked from anywhere in the US as long as you have high speed internet and a distraction-free home office area. Job Summary The Remote RADV Operations Analyst is primarily responsible for supporting The Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) audits by helping ensure member, enrollment, and claims data is accurate, complete, and audit?ready. In this role, you'll work closely with internal teams and partners to resolve data issues, track audit progress, and contribute to successful, compliant RADV submissions in a collaborative healthcare environment.

Pay:

$25+ an hour based on experience (overtime will be paid at 1.5 times the normal hourly pay rate).

Hours:

Full Time - Monday-Friday 8am - 4:30pm CST Why this Opportunity? Top ranked company in Fortune's "World's Most Admired Companies" 14 years in a row. This healthcare client is ranked number one in key attributes of reputation: Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of product Services and global competitiveness

Status:

Short Term Consultant. This is a short-term consulting opportunity offering the chance to gain experience with a Fortune 100 organization on high-impact initiatives. Strong performers may be considered for extensions or future opportunities based on business needs, as many roles within the organization begin on a consulting basis. Effective Date /

Tentative Start Date:

Interviewing Immediately

Job Duties:

Review and validate member demographics, enrollment, eligibility, claims, and pharmacy data to support RADV audit readiness Maintain and update Excel-based tracking tools, audit documentation, and reporting logs Identify, research, and resolve data discrepancies across systems, escalating risks and issues as needed Monitor reports to identify missing or inconsistent diagnoses impacting Hierarchical Condition Categories Prepare and deliver weekly project status updates and audit progress summaries Support RADV data submission planning and help correct data issues prior to submission Collaborate with cross-functional teams and external vendors to meet audit timelines and deliverables Stay current on CMS guidelines and regulatory requirements related to RADV Ensure compliance with HIPAA and data privacy standards when handling sensitive information Participate in project meetings and provide support for additional operational initiatives as priorities shift Requirements Minimum of 5 years of experience working within the healthcare industry, supporting claims, eligibility, membership, or provider data 5+ years of experience in an analytical, operations, or business support role Working knowledge of Microsoft Excel, including data review, reconciliation, and basic formulas High school diploma or equivalent A reliable high-speed internet connection (the faster the better!) Private, quiet, and distraction-free workspace in a room with a closed-door Highly Preferred Large corporation experience Health plan / managed care / healthcare industry experience Certified Professional Coder/Certified Risk Adjustment Coder 3+ years of U.S. Department of Health and Human Services RADV experience, including familiarity with: HHS risk adjustment models RADV audit protocols CMS guidance and manuals

WHO SHOULD APPLY?

If you have experience in healthcare operations, audit support, claims or eligibility analysis, risk adjustment, or CMS?regulated environments, we would love for you to apply! Apply to become part of the team that is not only changing people's lives for the better but changing the health care system for the next generations to come. About Us The CSI Companies is a recruiting firm established in 1994 that has been awarded "Best of Staffing" for 8 years in a row. We provide outstanding services to the world's leaders in the healthcare field as well as other organizations. For consideration, please submit your resume with all of your relevant experience included on it for immediate consideration. Only those candidates identified for an interview will be contacted.

Benefits Offered:

Weekly pay Medical, dental, and vision coverage Voluntary Life and AD&D coverage Paid Training Opportunity for advancement upon performance and availability and a recruiter will be in touch with you to schedule a phone screening!