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About ReveleerReveleer delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations navigating the complexity of value-based care. Trusted by 80+ customer organizations nationwide, the platform integrates data, analytics, and intelligent workflow automation into one governed system designed to support traceable documentation across diagnoses, quality measures, and submissions. With regulatory expertise and transparent, human-in-the-loop AI at its core, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.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 RISKSupport and participate in process and quality improvement initiativesConduct training related to ,RISK, platform usage, up date any training materials, and function as RISK SMEMonitor project statusWork on flexible projects with variable client/project specific guidelinesReview all Negative / Positive hitsManage 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/AAPCMinimum of 5 years of hands-on medical records experience5 Years of RISK and IVA experience3+ years of management experienceBackground in UR, QA and/or QI experience preferredStrong computer skills and high-speed internet access at homeCommitment to confidentiality of patient health informationProfessional, articulate and able to work independentlyAbility to manage teams and meet deadlinesBe able to conduct trainings in nonstandard time frames to meet abstractor needs and trainingClinical 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 salaryMedical, Dental and Vision benefits401k matchGenerous PTO planOur 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.
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