Records Retrieval Specialist

About the role

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.

Responsibilities

• 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.
• 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).

Qualifications

• 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.

Skills

• Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.