Medical Records Retrieval Specialist - Nashville

Humana • Nashville, TN

1d • Remote

About The Position

The Medical Records Retrieval Specialist conducts quality assurance audits of medical records and ICD‑9/10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. This is a remote role with field‑based responsibility, requiring travel to provider offices to retrieve, review, and validate medical records on‑site in or around the Nashville area. The Medical Records Retrieval Specialist performs moderately complex administrative and operational tasks in a remote and field‑based, structured environment, with a focus on accuracy, compliance, and efficiency.

Requirements

• Minimum 1 or more years of customer service experience.
• Minimum 1 or more years with medical records.
• Use Microsoft Teams and Outlook daily to coordinate meetings, manage calendars, and support internal communication.
• Experience handling high task volume across parallel workflows consistently, follow up, and a high standard of professional conduct.
• Knowledge or experience in health care environment/managed care (provider office, billing, coding, release of information, etc.)
• Must reside in the Nashville Metropolitan area – preferably Cheatham, Davidson, Dickson, Robertson, Rutherford, Sumner, Williamson, or Wilson counties.
• Ability to travel and occasionally stay overnight up to 50% of the time at peak season, as needed.
• Must have reliable transportation.
• Valid state driver's license.
• Maintain personal vehicle liability insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Nice To Haves

• Bachelor's degree in a related field.
• Knowledge or experience in health care environment/managed care.
• Knowledge of ICD-9/10 codes.
• Knowledge of medical terminology.
• Experience and comfort with EMR systems.

Responsibilities

• Collect medical records to ensure accuracy of member information and obtain provider signatures.
• Upload verified documents to Cotiviti centralized repository.
• Follow state and federal regulations as well as internal policies and guidelines while retrieving medical records.
• Interpret and apply departmental procedures to complete assignments with accuracy and efficiency.
• Use a laptop computer and a portable scanner and encrypted flash drive to retrieve medical records which will be uploaded into a database.
• Communicate with physician offices by phone and email to efficiently meet all deadlines.
• Maintain strict confidentiality and safeguard protected health information (PHI) in compliance with HIPAA guidelines.
• Independently manage workload within defined service level expectations.

Benefits

• medical benefits
• dental benefits
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term disability
• long-term disability
• life insurance
• bi-weekly payment for internet expense (for associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees