Lead Audit Retrieval Specialist - Medical Records (Remote)

Sharecare

85d

About The Position

Sharecare is the leading digital health company that helps people -- no matter where they are in their health journey -- unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. The mission of the Audit Fulfillment Program is to track, retrieve, & deliver timely, accurate medical record sets, for all valid use cases, to high-volume institutional requestors. This position is responsible for processing all release of information requests in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. Associate must at all times safeguard and protect the patient’s right to privacy by ensuring that only authorized individuals have access to the patient’s medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations.

Requirements

• High School Diploma (GED) required; degree preferred.
• 2+ years of ROI fulfillment experience with Sharecare HDS or 4 years external required.
• Demonstrated leadership skills.
• Demonstrated ability to prioritize, organize and meet deadlines.
• Demonstrated documentation and communication skills.
• Availability to work from 6am to 6pm, or any combination of hours in between; Saturday’s included.
• Demonstrated ability to maintain productivity and quality performance.
• Basic knowledge of medical records and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Experience with Microsoft Office products.
• Knowledgeable in multiple EMR platforms.
• Displays strong interpersonal skills with both team and customers.

Responsibilities

• Completes release of information requests including retrieving patient’s medical chart and returning chart, scanning medical record accurately and correctly and transmitting daily, according to requests, established procedures, and established standards of quality and productivity.
• Specifically focused on retrieval projects for health plan and CMS campaigns, including but not limited to: HEDIS, DRG, Risk Adjustment, Payment Integrity, RAC, CMS Audits.
• Receive and review audit requests from external entities, ensuring understanding of requirements and deadlines.
• Identifies audit use case, validates requests and authorizations for release of medical information according to established procedures.
• Maintains up-to-date client account logins/credentials for all assigned locations, including tracking expiration dates and renewal requirements.
• Collaborate with audit response teams to coordinate efforts and ensure timely submission of requested materials.
• Monitor audit timelines and deadlines, providing regular updates to management and stakeholders on progress and status.
• Performs quality checks on all work to assure completeness, accuracy, and compliance with audit criteria and requirements.
• Maintains equipment in excellent operating condition (inside and out).
• Provides excellent customer service by being attentive and respectful; insures understanding of customer request and follows-through as promised; and being proactive in identifying client concerns, or problems.
• May receive incoming requests including opening mail, telephone inquiries, and retrieving facsimile inquiries, depending on the needs to the client.
• Maintains a neat, clean, and professional personal appearance and observes the dress code established.
• Maintains a clean and orderly work area, insures that records and files are properly stored before leaving area.
• Maintains working knowledge of the existing state laws and fee structure.
• Works within scope of position and direction; willingly accepts assignments and is available to take on additional facilities or help out during backlogs.
• Carries out responsibilities in accordance with client/site policies and procedures, including HIPAA, state/federal regulations related to operations, and labor regulations.
• Maintains confidentiality, security and standards of ethics with all information.
• Works with privileged information in a conscientious manner while releasing medical records in an efficient, effective, and accurate manner.
• Provides onboarding and training services to new employees as required.
• Keeps Department Lead informed of concerns or issues regarding quality, connectivity, client concerns etc. that may inhibit Sharecare HDS performance or service expectations for customers.
• Produces periodic reporting as requested.
• Completes and maintain the AHIOS Certificate Program to become a Certified Release of Information Specialist.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees