Clinical Operations Lead

Reveleer; Northern (KY); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

401k match

Medical, Dental and Vision benefits

Generous PTO plan

Job summary

Reveleer, a leader in risk adjustment and clinical data management, offers a remote opportunity for a Clinical Operations Lead. You will support managers with clinical pends, provide over-read feedback, and drive cross-functional collaboration to roll out product releases across a remote team.

The role requires 5+ years of coding experience with Medicare/Commercial HCC, AHIMA/AAPC certifications, and strong communication skills to engage internal and external stakeholders. Remote, nationwide.

Qualifications

• Current Coding Certification through AAPC and/or AHIMA.
• Minimum of 5 years coding experience with Medicare and Commercial Risk Adjustment (HCC).
• Facility (OPPS/IPPS) coding experience preferred.
• RADV experience preferred.
• Excellent verbal and written communication skills with internal and external customers.

Responsibilities

• Assist Managers with clinical pends.
• Assist with over-read feedback.
• Assign manual assignments.
• Assist with individual data entry production (MRR or OR1).
• Review reports daily for QA scores during the season(s).
• Ensure collaboration among cross functional teams for the roll out of product releases.
• Additional duties as necessary to meet client obligations.

Skills

Independent worker

Communication skills

Detail-oriented

Remote collaboration

Adaptable

Medical terminology

Education

Coding certifications (CPC/CPC-P/CPC-H/CPC-I, CRC, CCS, RHIT, RHIA)

Job description

Clinical Operations Lead

Remote Opportunity

About Reveleer

Reveleer delivers a unified platform spanningrisk adjustment,quality improvement,clinical intelligence, andmember managementfor 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.

What You’ll Do:

• 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

About You:

• 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)
• Additional experience in facility (OPPS/IPPS) coding experience is preferred
• Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred
• Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers

Experience and Skills:

• 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

WHAT YOU’LL RECEIVE:

• Competitive salary
• Medical, Dental and Vision benefits
• 401kmatch
• Generous PTO plan

Our 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.