Retrieval Specialist JHP

Jefferson Health Plans•Philadelphia, PA

8d•Onsite

About The Position

The Retrieval Specialist is a non-clinical, operations-focused role responsible for executing the day-to-day medical record retrieval activities supporting all retrievals for Jefferson Health Plans (e.g., Quality/HEDIS, SIU, Care Management, and Risk Adjustment programs). Working from assignments, the Retrieval Specialist contacts providers using the appropriate retrieval method, follows-up to ensure record receipt, and intakes and stores retrieved records according to JHP's established naming and filing conventions. This role is central to the shared service team's ability to meet program timelines and maintain a complete, well-organized record of retrieval activity. The Specialist maintains accurate work queue information, documents provider outreach and retrieval outcomes, and escalates issues or incomplete records in accordance with established procedures.

Requirements

High School Diploma/GED
3 years in medical record retrieval, health information management, medical office operations, or managed care administrative functions.
Experience working in a high-volume work queue or deadline-driven operations environment.
Experience supporting Medicare Advantage, Medicaid, or other CMS-regulated health plan programs.
Strong attention to detail with a consistent commitment to accuracy and quality across all aspects of work.
Strong customer service skills and professional judgment when engaging with external partners and internal stakeholders.
Ability to manage a high-volume workload, prioritize tasks effectively, and consistently meet deadlines with minimal supervision.
Ability to apply established standards, conventions, and procedures consistently and correctly across all aspects of the role.
Clear written and verbal communication skills, with the ability to interact professionally with both external partners and internal stakeholders.
Proficiency with Microsoft Office Suite, including Excel, Outlook, and Teams.
Ability to conduct professional, persistent, and solution-oriented outreach across multiple communication channels.
Ability to maintain accurate records and ensure tracking systems and documentation are current and up to date in real time.
Strong organizational, multitasking, problem-solving, and time-management skills.
Ability to work both independently and collaboratively as part of a team.
Ability to escalate issues proactively and always maintain work / documentation in audit-ready condition.
Ability to travel
DL - Driver's License_PA - State of Pennsylvania or
DL - Driver's License_NJ - State of New Jersey or
DL - Driver's License_DE - State of Delaware

Nice To Haves

Associate’s Degree in health information management, Healthcare Administration, or a related field.
Experience with OnBase or another electronic document management system.
Experience with any clinical document retrieval tracking tool.
Experience navigating electronic medical record (EMR) or provider portal systems.
Ability to learn and work effectively in electronic document management and retrieval tracking platforms.
CPHIMS - Certified Professional Healthcare Information & Management Systems - Healthcare Information and Management Systems Society or
CHDA - Certified Health Data Analyst - American Health Information Management Association or
CCA - Certified Coding Associate - American Health Information Management Association or
RHIT - Registered Health Information Technician - American Health Information Management Association

Responsibilities

Interacts with co-workers, visitors, and other staff in a professional manner consistent with organizational values.
Receives and reviews assigned work queues from the Manager, assesses provider outreach method and program priority, and organizes workload to meet established retrieval deadlines and productivity targets.
Maintains an accurate and up-to-date personal work queue in the designated tracking system, including real-time status updates and clear daily and weekly prioritization.
Conducts provider outreach through assigned retrieval methods, which may include electronic medical record portals, fax, mail, and on-site retrieval as applicable.
Documents all outreach attempts, follow-ups, provider responses, and retrieval outcomes in the designated tracking system in a timely and consistent manner.
Reviews received records for completeness and verifies alignment with the original retrieval request prior to storing any documentation.
Applies established naming conventions, uploads records into the designated document management system, and confirms successful indexing and storage.
Tracks retrieval status supports cycle-end reconciliation and maintains complete work queue data to support reporting and performance monitoring.
Follows standard operating procedures and applicable regulatory requirements, including HIPAA, when handling medical records and protected health information.
Escalates provider issues, incomplete records, system concerns, and other operational barriers promptly to the Team Manager or designated escalation contact (e.g., Provider Relations).
Supports quality review, training, process improvement initiatives, and other shared team activities as assigned.
Maintains effective communication with provider offices and internal partners regarding retrieval status and outstanding documentation needs.