Clinical Coding Manager

Reveleer is a healthcare data and analytics company that uses Artificial Intelligence to give health plans across all business lines greater control over their Quality Improvement, Risk Adjustment, and Member Management programs. With one transformative solution, the Reveleer platform enables plans to independently execute and manage every aspect of enrollment, provider outreach and data retrieval, coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data sets, and subject matter expertise, Reveleer provides complete record retrieval and review services so health plans can confidently plan and execute risk, quality, and member management programs to deliver more value and improved outcomes.

Salary Range: $80,000 - $90,000

Job Summary:

The Clinical Coding Manager is the lead expert on Risk Technical Specifications and related initiatives at Reveleer and will have knowledge and ability to manage other program types. This leader will be responsible for having management and oversight responsibility for a large team of coders and QA over-readers. The Clinical Coding Manager has responsibility for ensuring that Reveleer delivers the highest quality coding in the industry while adhering to strict project deadlines for year-round clinical data analysis. This position must have the ability to code/over-read and be familiar with ICD-10 codes and the different HCC models.

The Clinical Coding Manager must have excellent time management, communication, and organizational skills, and be comfortable in client- facing role, as well as supporting conversations with regulators and auditors.

Responsibilities Include:

  • Developing, documenting, and implementing comprehensive training on Reveleer’s coder tools
  • Improving and updating all training materials and job aids for coders.
  • Developing incentive programs to uphold quality results and timely outcomes.
  • Maintaining up-to-date expertise re: Compliance Audit updates.
  • Translating Technical Specifications for and working with Reveleer’s product development team to ensure that Reveleer’s Medical Record Review platform reflect all new information.
  • Building a highly effective QA program that ensures Reveleer codes at a 95% accuracy rate or higher.
  • Closely monitoring work queues and chart inventories to ensure that they are cleared daily.
  • Participating in weekly client status calls to discuss progress and issues.
  • Participating in national training programs and conferences both as a participant and as an industry thought leader.

Preferred Skills:

  • Ability to adapt to constantly changing priorities in managing a wide range of projects.
  • Must be able to work independently and in a team environment.
  • Excellent written, communication and presentation skills with the ability to explain and write complex information.
  • Proficiency in using the following software applications: MS Word, Excel, PowerPoint, web-based/SaaS tools, and MS Outlook (email, calendar, etc.)

Required Experience / Education:

  • Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA etc.) through AAPC and/or AHIMA
  • Minimum of 5+ years of experience managing Risk Adjustment in a health plan or medical record review vendor setting.
  • Minimum of 2 years actually performing Risk Adjustment Coding
  • Experience in developing and updating training materials and implanting training programs.
  • Customer service experience a plus.

What You’ll Receive:

  • Competitive salary
  • Medical, dental, and vision benefits
  • 401k
  • Generous PTO & holidays

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.