Records Retrieval Specialist

Humana • Harrisburg, PA

2d • Hybrid

About The Position

Become a part of our caring community 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 Pennsylvania and its surrounding counties, reporting directly to the Risk Adjustment Supervisor. As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: Collect medical records and conduct research to ensure accuracy of member information and obtain provider signatures. Travel will consist of driving to locations close to your home in an assigned territory and other areas as needed. Overnight travel may be required within the Northeast region on occasion. Collaborate with provider offices through phone calls and visits. Use multiple EMR systems to access records following all HIPAA guidelines. Use a laptop computer, portable scanner, and external thumb drive to retrieve medical records which will be uploaded into a database. Schedule appointments and visits to physician offices in a timely, efficient manner to meet all deadlines. Will assist with regional phone calls and administrative projects.

Requirements

• 1 or more years of experience working with various Electronic Medical Records (EMR) systems.
• 1 or more years of experience in a hospital and/or provider setting.
• Ability to travel overnight occasionally within the region (Northeast).
• Must have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
• Self-provided internet service must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Experience using Microsoft 365 and associated applications including Word, Excel, and Teams.
• Previous experience in a managed care setting.
• Familiarity with medical terminology and/or ICD-10 codes.
• Medical record retrieval experience.

Responsibilities

• Conduct 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.
• Collect medical records and conduct research to ensure accuracy of member information and obtain provider signatures.
• Travel to provider offices to retrieve, review, and validate medical records on site.
• Collaborate with provider offices through phone calls and visits.
• Use multiple EMR systems to access records following all HIPAA guidelines.
• Use a laptop computer, portable scanner, and external thumb drive to retrieve medical records which will be uploaded into a database.
• Schedule appointments and visits to physician offices in a timely, efficient manner to meet all deadlines.
• Assist with regional phone calls and administrative projects.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed