Clinical Operations Lead

This is a fully remote position, open to applicants in United States.

📋 Description

• Support Managers with clinical pend processes.

• Provide feedback on over-reads.

• Allocate manual tasks.

• Aid in individual data entry productivity (MRR or OR1).

• Daily review of reports for QA scores during the season(s) for abstractors, coders, and HPs.

• Facilitate collaboration among cross-functional teams for product release rollouts.

• Perform additional tasks as required to fulfill client obligations.

• Engage with management and remote coding staff.

• Clarify complex information.

⛳️ Requirements

• Valid Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA, etc.) from AAPC and/or AHIMA.

• At least 5 years of coding experience with a specific focus on Medicare and Commercial Risk Adjustment, including Hierarchical Condition Category (HCC).

• Preferred additional experience in facility (OPPS/IPPS) coding.

• Preferred additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV).

• Exceptional verbal and written communication skills, capable of effectively engaging with both internal and external stakeholders.

• Ability to operate independently in a dynamic remote setting with minimal oversight and guidance.

• Capability to interact with management and remote coding personnel.

• Strong organizational skills with a keen attention to detail.

• Ability to adjust to changing priorities while managing a diverse array of projects.

• Open-minded and adaptable to new ideas and changes.

• In-depth knowledge of medical terminology, anatomy, and pharmacology.

• Proficient in using official coding resources for research and problem-solving.

• Advanced computer skills and familiarity with the required software necessary for job functions.

• Excellent written and communication abilities, with the talent to elucidate complex information.

• Must meet E-Verify requirements for new hires.

🏝️ Benefits

• Competitive salary.

• Medical, Dental, and Vision insurance.

• 401k matching program.

• Generous PTO plan.