About this role
About Reveleer
Reveleer 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.
About the Role
We are seeking a Retrieval Team Lead to join our Retrieval Operations team. This role leads a team of Retrieval Specialists (PSRs) who connect with the onshore team daily to understand client process requirements and guidelines. The Team Lead owns team production, retrieval completion rate, turnaround time, quality, and compliance targets, and drives performance through real-time monitoring, coaching, and process improvement. The role also reports team performance to leadership, escalates provider and project risks, and manages engagement, retention, and skill development within the team. The role supports a large-scale retrieval program (approximately 500,000 chases, beginning with the October 2026 go-live), owns the relationship with the program’s highest-volume Address IDs (AIDs), and serves as the first line of response for provider escalations.
Key Responsibilities
- Production Management: Plan, monitor, and manage team production (provider contacts, chart requests, and charts retrieved) through hourly/daily tracking and performance interventions to meet or exceed monthly production target.
- Allocate Chase/Address ID inventory by project, provider, and retrieval channel, and use real-time monitoring to meet project retrieval rate goals, turnaround timelines, and client deadlines.
- Distribute and rebalance daily chase assignments across the PSR team based on AID priority, chase age, and retrieval deadlines; monitor individual PSR workloads and adjust assignments to keep the queue moving and prevent aged chases from stalling.
- Partner with the Team Manager on weekly volume planning and flag capacity gaps before they affect throughput.
- Track individual and team-level retrieval rate, pend rate, and productivity against program targets; flag underperformance or training gaps to the Team Manager and support corrective action plans.
- Quality & Retrieval Accuracy: Drive team-level quality to achieve consistent scores across all project audits through targeted feedback and corrective action plans.
- Ensure retrieved charts are complete, legible, and match the requested member, provider, and date-of-service range before submission, minimizing rework.
- Resolve pended and unresponsive chases through structured follow-ups, escalations, and alternate retrieval channels, and keep chase statuses and notes accurate in the retrieval system.
- Large AID Relationship & Provider Contact: Serve as the primary point of contact for the program’s highest-volume AIDs, maintaining direct relationships with provider office staff.
- Monitor retrieval performance for large AIDs and proactively address barriers before they affect chase completion.
- Coordinate directly with provider offices on record request logistics, portal access, and recurring retrieval issues.
- Provider Escalation Management: 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 that reduce recurring issues.
- Escalate unresolved or systemic provider issues to the Team Manager with a clear summary and a recommended next step.
- Process Improvement: Identify, propose, implement, and document process improvement initiatives that positively impact production efficiency and resource utilization, production improvement.
- Use operational data, provider feedback, pend reasons, and team input to identify improvement opportunities, and document each initiative with clear before-vs-after impact on productivity and retrieval rate.
- Process Adherence & Documentation: Ensure PSR adherence to standard retrieval processes, procedures, and documentation requirements.
- Maintain accurate, current records on AID assignments, escalation status, and chase ownership.
- Support the Team Manager with input on process updates and standard operating procedure (SOP) revisions.
- People Engagement & Retention: Drive team retention through structured engagement, coaching, skill development, performance feedback, and recognition, maintaining annual voluntary attrition rate.
- Use stay interviews, early warning signals (attendance dips, performance trends), career-pathing, and cross-training to proactively retain talent.
- Coaching & Development: Mentor and coach Retrieval Specialists to improve provider communication, objection handling, productivity, and knowledge of retrieval workflows.
- Support the team in completing soft-skill courses via Rev University.
- Onboard and train new PSRs on chase workflows, AID ownership, pend code handling, and platform agent hand-offs.
- Provide day-to-day feedback and ongoing refresher coaching on retrieval best practices, call quality, and documentation standards, based on chase outcomes.
- Maintain training materials and job aids, updating them as workflows or systems change.
- Compliance: Ensure zero compliance issues within the team; complete all mandatory training for self and team on time.
- Ensure adherence to client requirements, HIPAA, and internal retrieval guidelines; escalate deviations to the Team Manager and training team, and share training needs promptly based on identified knowledge gaps.
- Ensure all team members complete PKT (Post Knowledge Test) and process certification assessments as required.
- Verify requester and recipient details before any record exchange, and safeguard protected health information (PHI) at all times.
- Communication & Reporting: Ensure timely and accurate communication and reporting to leadership on production, retrieval rate, turnaround time, quality, and team performance.
- Promptly escalate issues, risks, and process deviations to the Team Manager to enable timely resolution and maintain workflow continuity.
- Actively participate in process training, audits, calibration sessions, and client or project review discussions.
- Collaborate with the Team Manager, peers, and cross-functional teams (provider relations, onsite retrieval, coding, and client services) to resolve provider issues and escalations.
Required Qualifications
- Minimum 5 years of experience in US healthcare medical record retrieval, including at least 2 years in an SME or supervisory capacity.
- Working knowledge of retrieval channels (fax, mail, EMR remote access, portal, onsite, and upload) and of the chart chase lifecycle , including scheduling, pend management, and turnaround requirements.
- Working knowledge of risk adjustment and HEDIS retrieval workflows, including chase, AID, and pend code concepts.
- Strong working knowledge of HIPAA, PHI handling, and release-of-information requirements , along with medical record structure and basic medical terminology.
- Proven track record of consistently meeting or exceeding production, retrieval rate, and quality targets.
- Experience with EMR/EHR systems.
- Proficiency in Excel and comfort working within chase or case management systems.
- Experience managing provider-facing communication, including resolving access or outreach escalations directly.
Preferred Education Background
- Graduate Degree — Bachelor’s degree in any discipline
- Domain Exposure — Prior experience in US healthcare BPO, HIM, or revenue cycle processes is an added advantage.
- Program Exposure — Direct experience supporting Medicare Advantage or ACA health plan retrieval programs.
- Training Experience — Prior experience formally training or onboarding new hires in a call center or retrieval operations setting.
Skills & Competencies
- Strong leadership, coaching, and team management skills.
- Strong knowledge of medical record retrieval workflows, provider office operations, and HIPAA compliance.
- Strong analytical ability with the capacity to interpret production, retrieval rate, aging, quality, and attrition data to drive decisions.
- Ability to handle difficult provider conversations, overcome objections, and resolve complex retrieval escalations.
- Excellent verbal and written communication skills, with the ability to report clearly and promptly to leadership, including experience delivering training or coaching.
- Strong process-improvement mindset with the ability to identify, document, and implement operational efficiencies.
- Ability to manage multiple retrieval projects and adapt to shifting client priorities and deadlines.
- Strong organizational skills, with the ability to manage and rebalance work assignments across a team in a fast-paced environment.
- Familiarity with chart tracking tools; willingness to work US shift hours.
- Ability to drive employee engagement and retention through proactive people management.
