Hybrid Risk Adjustment Chart Retrieval Specialist

Paycom; Huntington Beach (CA); Hybrid; USD 31.000 - 36.000; Vollzeit

Zusammenfassung

Clever Care Health Plan in Huntington Beach, CA is seeking a Risk Adjustment Coordinator, Chart Retrieval. The role manages end-to-end medical record retrieval to support the Medicare Advantage RADV program, coordinating with PCP offices, hospitals, and providers to improve timeliness and accuracy.

Responsibilities include validating records for member IDs and dates, ensuring completeness and legibility, and escalating issues to meet regulatory deadlines.

Qualifikationen

• High school diploma required; degrees preferred in HIM or Health Admin.
• Minimum two years of experience in medical record retrieval or risk adjustment.
• Experience contacting PCP offices, hospitals, and providers.
• Knowledge of HIPAA and secure data handling.
• Experience with RADV and coding validation is preferred.

Aufgaben

• Manage chart retrieval requests from initiation to closure.
• Contact PCP offices, IPAs, hospitals by phone, fax, or portal.
• Validate records for member/date/service accuracy and completeness.
• Coordinate on-site or remote retrieval as needed.
• Maintain audit-ready records and documentation for RADV.
• Track status and escalate delays to improve retrieval time.

Kenntnisse

Telephone communication

Written communication

Relationship management

Follow-up skills

High attention to detail

Ausbildung

Health Information Management degree

Healthcare Administration degree

Tools

Microsoft Outlook

Excel

Word

Teams

Electronic fax

Provider portals

Workflow systems

Document imaging tools

Jobbeschreibung

Clever Care Health Plan in Huntington Beach, CA is seeking a Risk Adjustment Coordinator, Chart Retrieval. The role manages end-to-end medical record retrieval to support the Medicare Advantage RADV program, coordinating with PCP offices, hospitals, and providers to improve timeliness and accuracy.

Responsibilities include validating records for member IDs and dates, ensuring completeness and legibility, and escalating issues to meet regulatory deadlines.