Note: The job is a remote job and is open to candidates in USA. Reveleer delivers a unified platform for risk adjustment, quality improvement, clinical intelligence, and member management in value-based care. The Clinical Operations Lead supports clinical operations by managing coding workflows, quality assurance reviews, assignments, data entry, and cross-functional product release collaboration.
Responsibilities
- Assisting Managers with clinical pends
- Assisting with over-read feedback
- Assigning manual assignments
- Assisting with individual data entry production (MRR or OR1)
- Reviewing reports daily for QA scores during the season(s) (abstractors, coders, HPs)
- Ensure collaboration among cross functional teams for the roll out of product releases
- Additional duties as necessary to meet the obligations to our clients
Skills
- Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA etc.) through AAPC and/or AHIMA
- Minimum of 5 years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC)
- Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers
- Ability to work independently in a fast-paced remote environment with minimal supervision and guidance
- Ability to interact with management and remote coding personnel
- Possess strong organizational skills and attention to detail
- Ability to adapt to changing priorities while managing a wide range of projects
- Adaptive and flexible to new ideas and change
- Advanced knowledge of medical terminology, anatomy and pharmacology
- Advanced skills utilizing official coding resources for research and problem solving
- Advanced skills and knowledge of computers, use of required software to perform job functions
- Excellent written and communication skills and the ability to explain complex information
- Additional experience in facility (OPPS/IPPS) coding experience is preferred
- Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred
Benefits
- Remote opportunity
- Medical, Dental and Vision benefits
- 401k match
- Generous PTO plan
Company Overview