Intake - Chart Retrieval Associate II (Fixed Term Employment)

UST USource; Pateros; On-site; PHP 279,000 - 424,000; Part time

Job summary

UST USource is seeking an Intake – Chart Retrieval QRM Associate to review, validate, and process medical records for quality review and case management. The role requires meticulous attention to detail, strong analytics, and ability to work across multiple applications while ensuring HIPAA compliance.

Responsibilities include collaborating with RNs and coders, verifying patient identifiers, handling PHI securely, and routing cases by urgency to meet TATs and NCQA standards.

Qualifications

• Any college education.
• 6+ months of Healthcare BPO experience.
• Ability to multitask across multiple applications.
• Strong analytical skills with attention to detail.
• Excellent interpersonal and teamwork abilities.
• Willing to accept a 6-month contract.

Responsibilities

• Collaborate with RNs, Medical Coders, and healthcare professionals to ensure accurate case management.
• Review retrieved medical records for legibility, completeness, and correct patient identifiers.
• Handle PHI with confidentiality in line with HIPAA and client security protocols.
• Analyze records to determine the clinical pathway and next steps.
• Route cases by urgency to meet turnaround times and NCQA standards.
• Maintain accuracy across EMR/EHR systems.

Skills

Analytical skills

Attention to detail

Multitasking

Team player

Interpersonal skills

Education

Any college education

Tools

Microsoft Excel

EMR/EHR systems

Job description

The Intake – Chart Retrieval QRM Associate is responsible for reviewing, validating, and processing medical records to support quality review and case management activities. This role requires a high level of attention to detail, strong analytical skills, and the ability to work efficiently across multiple applications while ensuring compliance with HIPAA, client requirements, and NCQA standards.

Key Responsibilities

• Collaborate closely with Registered Nurses (RNs), Medical Coders, and multidisciplinary healthcare professionals to ensure seamless communication and accurate case management
• Review retrieved medical records to verify that they are legible, complete, and accurately matched to patient identifiers, including name, date of birth, dates of service, provider, and facility information
• Handle all Protected Health Information (PHI) with strict confidentiality while ensuring full compliance with HIPAA regulations and client security protocols
• Analyze received medical records and file data to determine the appropriate clinical pathway and next steps
• Route cases to the appropriate clinicians based on urgency levels (urgent versus non-urgent) to ensure adherence to established turnaround times (TATs) and NCQA standards
• Maintain accuracy and consistency when working with patient records and clinical documentation across various Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems
• Utilize Microsoft Excel to organize and maintain departmental files, track case status, and produce accurate weekly reports
• Perform quality checks to ensure medical records meet client and organizational requirements
• Manage multiple priorities and applications while maintaining productivity, accuracy, and service-level expectations

Qualifications:

• Any college education
• At least 6 months of Healthcare BPO work experience
• Ability to multitask across multiple applications
• Strong analytical skills with excellent attention to detail
• Great team player with excellent interpersonal skills
• Amenable to 6 months contract

Successful hires will be asked to provide NBI clearance, Former Employment documents among others