Clinical Risk Adjustment QA Coding Lead

Summary

Join Reveleer, a pioneering value-based care technology platform, as a Clinical Risk Adjustment QA Lead. This remote position involves assisting managers with clinical pends, over-read feedback, and manual assignments. You will also review daily reports for QA scores and ensure collaboration among cross-functional teams. The ideal candidate possesses a current coding certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA), at least 5 years of coding experience with Medicare and Commercial Risk Adjustment knowledge, and excellent communication skills. Reveleer offers competitive pay, comprehensive benefits, and a supportive remote work environment.

Requirements

• 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

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

Preferred Qualifications

• 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

• Competitive pay
• Medical, Dental and Vision benefits including HSA/FSA
• 401k with Employer Match
• 100% paid short term and long-term disability insurance
• PTO plan and 10 paid company holidays