Medical Records Specialist

About the role

We are seeking a detail-oriented and dedicated Medical Records Retrieval Specialist to support HEDIS/QARR quality initiatives, CMS Risk Adjustment projects, and other healthcare audits and studies. This role involves working directly with provider offices, clinics, and healthcare facilities to coordinate medical record retrieval, review documentation, and ensure compliance with established healthcare standards and regulations.

Responsibilities

• Coordinate with provider offices, clinics, and healthcare facilities to retrieve medical records for quality reviews and audits.
• Schedule and conduct onsite medical record reviews with high-volume providers.
• Support HEDIS/QARR initiatives, CMS Risk Adjustment projects, Retrospective Reviews, and RADV audits.
• Review medical records for documentation discrepancies and recommend appropriate corrective actions.
• Enter, track, and maintain accurate findings in centralized databases.
• Organize, scan, and maintain medical records in a secure central repository.
• Educate providers and office staff on CMS documentation requirements and medical record eligibility criteria.
• Follow up on outstanding requests and escalate unresolved retrieval issues to management.
• Maintain strict confidentiality and comply with HIPAA and applicable state and federal regulations.
• Participate in training sessions, quality improvement audits, surveys, and special projects as assigned.

Qualifications and Skills

• Knowledge of HEDIS/QARR standards and CMS Risk Adjustment criteria.
• Experience with medical records retrieval, medical record management, healthcare administration, or a related field preferred.
• Strong data entry skills and familiarity with databases or electronic medical record systems.
• Excellent organizational skills and the ability to manage multiple requests and deadlines.
• Strong attention to detail and the ability to identify documentation discrepancies.
• Excellent verbal and written communication skills.
• Understanding of HIPAA requirements and medical record confidentiality.
• Ability to work independently and collaboratively in a fast-paced environment.

Pay

Hourly Pay: $21-$22 per hour

Employment Type: Long-term temporary assignment

Work Environment: Healthcare provider offices and administrative settings, with onsite provider visits as required by the role.