Risk Adjustment (HCC Coding) Team Lead

About the role

Reveleer provides a unified platform for risk adjustment, quality improvement, clinical intelligence and member management for health plans and providers. The Risk Adjustment Team Lead oversees day-to-day coding and abstraction operations, drives team productivity and quality, and ensures adherence to coding guidelines, regulatory requirements and client commitments. The role involves hands-on operational work, team coaching, performance monitoring and cross-functional collaboration.

Key responsibilities

• Monitor daily team productivity and ensure coding targets, quality standards and turnaround times are met
• Allocate and balance coding assignments by project priorities, workload and team capacity, and track individual and team performance
• Ensure accurate HCC coding in line with ICD-10-CM guidelines and risk adjustment requirements, review quality reports and over-read feedback, and support resolution of complex coding cases
• Coach and mentor coders, run refresher training, support new-hire onboarding and promote accountability and continuous learning
• Support coding audits and RADV activities, and ensure compliance training and coding assessments are completed on time
• Report productivity, accuracy, quality scores and turnaround times, identify workflow inefficiencies and escalate risks to management
• Collaborate with managers, QA teams and stakeholders on coding issues, guideline updates and process changes

Required profile

• Minimum 6 years of medical coding experience, with strong expertise in Medicare Advantage and commercial risk adjustment, including HCC coding
• Current coding certification through AAPC and/or AHIMA (e.g., CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA)
• Prior experience as an SME, senior coder, quality reviewer or team lead; supervisory experience strongly preferred
• Demonstrated ability to meet productivity, accuracy and quality targets

Required skills

• Strong knowledge of ICD-10-CM, HCC models, risk adjustment methodologies, medical terminology, anatomy and pharmacology
• Experience in HCC coding, quality reviews, over-reads and coding audit resolution
• Proficiency in Microsoft Excel and coding platforms
• Analytical, problem-solving, communication and team management skills
• Preferred: RADV audit experience and facility coding (OPPS/IPPS)