Clinical Coding Retrieval Coordinator

Healthfirst, Inc.; New York (NY); Hybrid; USD 69,000 - 100,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401k contributions

Incentive and recognition programs

Job summary

Healthfirst, Inc. is seeking a Clinical Coding Retrieval Coordinator to support RADV medical records acquisition and regulatory compliance.

This hybrid role spans remote work, office-based duties at 100 Church Street in New York, and travel to providers across NYC metro, Westchester, Long Island, New Jersey, Connecticut and Pennsylvania as needed. You will coordinate cross-functional teams, manage high-volume retrieval workflows, and prepare status updates for internal stakeholders while

Qualifications

• HS diploma or GED from an accredited institution.
• 2-3 years in medical record retrieval in a health plan/provider setting or administrative experience in lieu of healthcare setting.
• Strong writing, time management, critical/creative thinking, communication, and problem-solving skills.
• Strong working knowledge of Microsoft Office Suite and Outlook.

Responsibilities

• Expand and improve medical records acquisition for RADV risk adjustment program.
• Perform medical record reviews to ensure records align with RADV clinical documentation specifications.
• Engage in medical record retrieval efforts for RADV and internal audit activities.
• Collaborate with Compliance, Risk Adjustment, and HIM teams across provider sites to meet CMS retrieval deadlines.
• Ensure medical records are accurately scanned and stored in Healthfirst systems and comply with CMS RADV documentation requirements.
• Track retrieval progress, maintain dashboards, and escalate risks or delays.

Skills

Strong writing

Time management

Communication

Problem-solving

Education

HS diploma or GED

Associates degree or higher

Tools

MS Office

Outlook

EMR systems

Job description

The Clinical Coding Retrieval Coordinator is responsible for supporting Healthfirst initiatives and regulatory requirements related to RADV medical records acquisition. This position is provider facing. This position has a hybrid work location: Remote, office based, and in the field as needed. Office location is 100 Church Street, New York.

Duties & Responsibilities

Responsible for expanding and improving medical records acquisition for RADV risk adjustment program

Performs medical record reviews to ensure medical records are consistent with RADV clinical documentation specifications

Engages in medical record retrieval efforts for RADV and internal audit activities

Works cross-functionally with Compliance, Risk Adjustment, and HIM teams at different providers and hospitals sites to meet CMS’s retrieval deadlines

Ensures medical records are accurately accounted for, scanned, and saved in the appropriate Healthfirst system

Ensures compliance with CMS RADV medical record documentation requirements

Tracks retrieval progress, maintain dashboards, and escalates risks or delays proactively

Strong communication skills are a must in order to maintain collaborative relationships with medical facilities

Travels to providers’ sites and hospitals to obtain medical records

Manages issues at a facility level in order to facilitate medical records acquisition

Coordinates multiple audit requests at the same time

Provides detailed updates on regulatory audits, projects, and initiatives to internal stakeholders during status updates meetings

Organizes and prepares PowerPoint presentations for project status reports

Maintains HIPAA compliance and ensure secure transmission of all PHI

Additional duties as necessary

Minimum Qualifications

HS diploma or GED from an accredited institution

2-3 years in medical record retrieval in a health plan/ provider setting or administrative experience in lieu of health care setting

Strong writing, time management, critical/creative thinking, communication, and problem-solving skills.

Strong working knowledge of Microsoft Office Suite and Outlook

Ability to travel around the NYC metro area, Westchester and Long Islandas well as New Jersey, Connecticut and Pennsylvania as necessary.

Preferred Qualifications

Associates degree or higher from an accredited institution

Prior experience in Managed Care/Health Insurance, in a health-related field or environment

Proficiency in multiple EMR systems (Epic, eCW, Athena, Cerner, etc).

Understanding of CMS RADV requirements and medical record documentation best practices

2-3 years of experience with chart requests/retrievals using Risk Adjustment modeling

2-3 years of experience identifying SOAP notes for different specialties in a hospital, physician, or insurance environment using Risk Adjustment, Commercial, and CRG Models

Additional Job Description

Strong attention to detail

Familiar with multiple EMR systems

Proven experience engaging and coordinating with provider offices and hospital HIM departments

Ability to manage high-volume workflows with extreme attention to detail and tight deadlines

Compliance & Regulatory Responsibilities

Noted above

License/Certification

N/A

Hiring Range*

Greater New York City Area (NY, NJ, CT residents): $68,900 - $99,620

All Other Locations (within approved locations): $61,300 - $89,440

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in good faith would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [e-mail] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your Rights