Risk Adjustment Coding Manager
Remote
As the industry’s pioneering value-based care (VBC) technology platform, Reveleer is purpose-built to solve the most pressing real-world challenges faced by providers and health-plan organizations today. By unifying retrieval, clinical intelligence, risk adjustment, quality improvement, and member management solutions into one intelligent, AI-powered system, Reveleer streamlines fragmented workflows to supercharge productivity, enhance care quality, and optimize performance on high-priority value-based initiatives.We are seeking a full time Clinical Coding Manager to oversee duties of Risk Adjustment and reporting.
What You'll Do:
- Oversee and/or perform an accurate medical record review for all RISK
- Support and participate in process and quality improvement initiatives
- Conduct training related to ,RISK, platform usage, up date any training materials, and function as RISK SME
- Monitor project status
- Work on flexible projects with variable client/project specific guidelines
- Review all Negative / Positive hits
- Manage RISK coding projects when needed- including project status and completing chart reviews for coding projects as needed.
Job Requirements:
- Must have a professional coding certificate through AHIMA/AAPC
- Minimum of 5 years of hands-on medical records experience
- 5 Years of RISK and IVA experience
- 3+ years of management experience
- Background in UR, QA and/or QI experience preferred
- Strong computer skills and high-speed internet access at home
- Commitment to confidentiality of patient health information
- Professional, articulate and able to work independently
- Ability to manage teams and meet deadlines
- Be able to conduct trainings in nonstandard time frames to meet abstractor needs and training
- Clinical Documentation Review: Analyze medical records and NLP results and validate that the clinical evidence meets the necessary requirements for submission and documentation. This includes making sure the documentation accurately reflects the patient’s conditions, treatment and services provided. Identify gaps, inconsistencies, and discrepancies in documentation that could impact patient care, quality reporting and reimbursement.
- Coding Support: Ensure documentation aligns with accurate code assignment and follow CMS’s coding guidelines for HCC risk adjustment coding.
- Clinical Knowledge: Maintain a deep understanding of medical terminology, disease processes, treatments, and procedures to accurately interpret and validate clinical documentation.
- Documentation Integrity: Safeguard the integrity and confidentiality of patient health information while handling medical records and sensitive data in accordance with HIPAA and other relevant regulations.
- Interdisciplinary Communication: Foster clear communication and collaboration between different healthcare departments, ensuring that accurate patient information is shared across the continuum.
What You'll Receive:
- 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
Salary Range: $80,000 - $90,000 / annuallyOur compensation reflects the cost of labor across several US geographic markets. Pay is based on several factors including market location and may vary depending on job-related knowledge, skills, and experience.Reveleer E-Verifies all new hires.Reveleer is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law.
