Clinical Coding Retrieval Coordinator

HF Management Services•New York, NY

4d•Hybrid

About The Position

The Clinical Coding Retrieval Coordinator supports Healthfirst initiatives and regulatory requirements related to RADV medical records acquisition. This provider-facing role has a hybrid work location, including remote work, office-based work at 100 Church Street in New York, and field work as needed. The coordinator supports medical-record retrieval, review, tracking, and audit activities, working with provider facilities and internal teams to meet CMS deadlines and documentation requirements. The position also maintains secure handling of protected health information and provides project and audit updates to internal stakeholders. The role requires travel to provider sites and hospitals across the NYC metropolitan area and, as necessary, Westchester, Long Island, New Jersey, Connecticut, and Pennsylvania. The hiring range is $68,900–$99,620 for residents of the Greater New York City Area (NY, NJ, CT) and $61,300–$89,440 for other approved locations. Healthfirst offers eligible employees medical, dental, and vision coverage, incentive and recognition programs, life insurance, and 401(k) contributions.

Requirements

High school diploma or GED from an accredited institution.
Two to three years of medical-record retrieval experience in a health plan or provider setting, or administrative experience in lieu of a healthcare setting.
Strong writing, time-management, critical and creative thinking, communication, and problem-solving skills.
Strong working knowledge of Microsoft Office Suite and Outlook.
Ability to travel around the NYC metro area, Westchester, Long Island, New Jersey, Connecticut, and Pennsylvania as necessary.
Strong attention to detail.
Proven experience engaging and coordinating with provider offices and hospital HIM departments.
Ability to manage high-volume workflows with extreme attention to detail and tight deadlines.

Nice To Haves

Associate degree or higher from an accredited institution.
Prior experience in managed care, health insurance, or a health-related field or environment.
Proficiency with multiple EMR systems, such as Epic, eCW, Athena, and Cerner.
Understanding of CMS RADV requirements and medical-record documentation best practices.
Two to three years of experience with chart requests and retrievals using Risk Adjustment modeling.
Two to three years of experience identifying SOAP notes for different specialties in a hospital, physician, or insurance environment using Risk Adjustment, Commercial, and CRG Models.
Familiarity with multiple EMR systems.

Responsibilities

Expand and improve medical-record acquisition for the RADV risk adjustment program.
Review medical records to ensure they meet RADV clinical documentation specifications.
Conduct medical-record retrieval for RADV and internal audit activities.
Work with Compliance, Risk Adjustment, and HIM teams at provider and hospital sites to meet CMS retrieval deadlines.
Ensure medical records are accurately accounted for, scanned, and saved in the appropriate Healthfirst system.
Ensure compliance with CMS RADV medical-record documentation requirements.
Track retrieval progress, maintain dashboards, and proactively escalate risks or delays.
Maintain collaborative relationships with medical facilities through strong communication.
Travel to provider sites and hospitals to obtain medical records.
Manage facility-level issues to facilitate medical-record acquisition.
Coordinate multiple audit requests concurrently.
Provide detailed updates on regulatory audits, projects, and initiatives to internal stakeholders during status meetings.
Organize and prepare PowerPoint presentations for project status reports.
Maintain HIPAA compliance and ensure secure transmission of all PHI.
Perform additional duties as necessary.