Retrieval Operations Lead

Job not on LinkedIn

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $21 - $28 / hour

⏰ Full Time

🟠 Senior

⚙️ Operations

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This company has sponsored H1B visas in the past.

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Reveleer

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

Reveleer is a healthcare technology company that specializes in providing an end-to-end platform for value-based care. Their platform leverages artificial intelligence to automate tasks, improve efficiency, and enhance patient care by consolidating risk adjustment and quality improvement workflows. Reveleer helps healthcare organizations streamline their operations through intelligent data acquisition, enhancing productivity and ensuring accurate reimbursement. With a focus on healthcare intelligence, Reveleer integrates with HIEs and EHR systems to improve care delivery and capture relevant diagnoses. They have a significant presence in the healthcare industry, working with various health plans to maximize their performance and patient outcomes.

📋 Description

• Serve as the primary point of contact for a program's highest-volume AIDs and maintain direct relationships with provider office staff • Monitor retrieval performance for large AIDs and proactively address barriers affecting chase completion • Coordinate with provider offices on record request logistics, portal access, and recurring retrieval issues • Distribute and rebalance daily chase assignments across the PSR team based on AID priority, chase age, and retrieval deadlines • Monitor PSR workloads and adjust assignments to keep the queue moving and prevent aged chases from stalling • Partner with the Retrieval Manager on weekly volume planning and flag capacity gaps • Onboard and train new PSRs on chase workflows, AID ownership, pend code handling, and platform agent hand-offs • Deliver ongoing coaching and refreshers on retrieval best practices, call quality, and documentation standards • Maintain and update training materials and job aids • Own first-line resolution of provider escalations related to retrieval outreach, record requests, or access issues • Document escalation patterns and root causes and recommend workflow or script changes • Escalate unresolved or systemic provider issues to the Retrieval Manager with a clear summary and recommended next step • Track individual and team retrieval rate, pend rate, and productivity against program targets • Provide day-to-day feedback and coaching to PSRs based on chase outcomes and call quality • Flag underperformance or training gaps and support corrective action plans • Ensure PSR adherence to standard retrieval processes, procedures, and documentation requirements • Maintain accurate records on AID assignments, escalation status, and chase ownership • Support process updates and standard operating procedure revisions

🎯 Requirements

• 2+ years of experience in healthcare operations, chart retrieval, risk adjustment, or HEDIS/quality program support • 1+ years of experience training, coaching, or leading the daily work of other individual contributors • Working knowledge of risk adjustment and HEDIS retrieval workflows, including chase, AID, and pend code concepts • Experience managing provider-facing communication, including resolving access or outreach escalations directly • Strong organizational skills, with the ability to manage and rebalance work assignments across a team in a fast-paced environment • Proficiency in Excel and comfort working within chase or case management systems • Excellent written and verbal communication skills, including experience delivering training or coaching • Direct experience supporting Medicare Advantage or ACA health plan retrieval programs preferred • Prior experience formally training or onboarding new hires in a call center or retrieval operations setting preferred • Must be able to work in the United States • E-Verify required for new hires

🏖️ Benefits

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