HEDIS/QARR Medical Records Retrieval Specialist

Phaxis; New York (NY); On-site; USD 29,000 - 30,000; Full time

Job summary

Phaxis is seeking a detail-oriented Medical Records Retrieval Specialist to support HEDIS, QARR, CMS Risk Adjustment, and related audits. You will coordinate with provider offices to retrieve records, review documentation, and ensure compliance with established healthcare standards.

The ideal candidate has strong organizational and communication skills, excellent attention to detail, and the ability to manage a high volume of medical records in a fast-paced environment.

Qualifications

• Knowledge of HEDIS/QARR standards and CMS Risk Adjustment criteria.
• Experience with medical records retrieval and management.
• Strong data entry skills and familiarity with EMR systems.
• Excellent organizational and communication skills.
• Ability to work independently in a fast-paced healthcare environment.

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 escalation 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.

Skills

HEDIS/QARR standards

CMS Risk Adjustment

Medical records retrieval

Data entry / EMR systems

HIPAA knowledge

Job description

Phaxis is seeking a detail-oriented Medical Records Retrieval Specialist to support HEDIS, QARR, CMS Risk Adjustment, and related audits. You will coordinate with provider offices to retrieve records, review documentation, and ensure compliance with established healthcare standards.

The ideal candidate has strong organizational and communication skills, excellent attention to detail, and the ability to manage a high volume of medical records in a fast-paced environment.