Medical Record Retrieval Specialist I (Hybrid)

Carefirst; Baltimore (MD); Hybrid; USD 41,000 - 76,000; Full time

Job summary

CareFirst BlueCross BlueShield in the DMV area seeks a Medical Record Retrieval Specialist I to coordinate provider outreach and manage timely record requests. You will ensure PHI protection and HIPAA compliance while maintaining accurate records in the provider database.

The role supports a portion of work from home and a portion at CareFirst locations based on business needs, with a focus on accuracy, timelines, and collaboration with internal teams.

Qualifications

• Education: high school diploma or GED; preferred associate degree.
• 3 years in healthcare operations or medical records retrieval.
• Knowledge of HIPAA and PHI protection requirements.

Responsibilities

• Coordinate and implement record retrieval activities with providers.
• Outreach to provider offices to obtain charts and ensure timely delivery.
• Maintain provider contact database and track records using standard tools.
• Protect PHI and ensure compliance with HIPAA and internal policies.

Skills

Provider outreach

PHI protection

HIPAA knowledge

MS Office

Education

High School Diploma

Associate's degree

Tools

Microsoft Office

Adobe Pro

Job description

Resp & Qualifications

PURPOSE

The Medical Record Retrieval Specialist I will coordinate and implement activities supporting accurate and timely document management and retrieval efforts, adherence to regulatory and project timelines, and protection of the privacy of individuals' health information according to HIPAA. This role will perform outreach to provider offices to coordinate record retrieval efforts and maintain the provider contact database. This role requires candidates to be located in the Maryland, Washington, DC, or Northern Virginia (DMV) area. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.

ESSENTIAL FUNCTIONS

• Contacts provider offices with a high degree of professionalism and confidence to communicate expectations, charts required, etc. Establishes relationships with providers and ROI (Request of Information) vendors. Assists providers offices with the process of sending medical records. Educates, trains, provides support to providers staff on the different methods to send medical records. Analyzes and monitors progress of incoming correspondence including medical records to determine which organizations will need additional outreach. Identifies, investigates, and resolves issues related to incoming correspondence.
• Conducts provider outreach and research to locate contact information of medical providers that may be practicing, retired, or otherwise relocated. Updates and maintains the Provider Database. Communicates professionally with medical facilities, third party vendors, and Company stakeholders.
• Develops tracking and monitoring methods for medical record requests. Manages and maintains medical records repository. Ensures accuracy, timeliness of record uploads, compliance with processes to protect PHI, and effective tracking of records and record requests. Performs processing tasks such as: sorting incoming mail, preparing documents for scanning, retrieving information from Right Fax, and moving documents as appropriate to the repository or vendor platform. Conducts retrieval of medical records via fax, mail, remote electronic medical record access or onsite visits at the provider location, using computer systems and applications for data entry, edits, and information retrieval as required.
• Assumes a key role in the development of new processes and tracking systems to support best practice record keeping and document management procedures. Identifies process issues and contributes to the design of solutions. Proactively implements process improvements. Assists internal team and provider groups to troubleshoot any logistical or technical issues regarding record requests or retrieval.

QUALIFICATIONS

Education Level: High School Diploma or GED.

Experience: 3 years' experience in healthcare operations, medical record retrieval, risk adjustment, audit support, provider outreach, health information management or related operational experience.

Preferred Qualifications

• Associate's degree in Healthcare Management, Health Information Management, Business or related field.
• Knowledge of medical record retrieval operations, provider workflows, and healthcare documentation requirements.

Knowledge, Skills and Abilities (KSAs)

• Ability to effectively communicate (oral and written) and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
• Strong organizational skills, ability to prioritize responsibilities with attention to detail.
• Knowledge of HIPAA, PHI protection requirements, and healthcare regulatory standards.
• Experience in using Microsoft Office (Excel, Word, Power Point, etc.) and Adobe Pro and demonstrated ability to learn/adapt to computer-based tracking and data collection tools.
• Self-motivated, able to take initiative, and work independently with minimal oversight to meet timelines, strong follow-through skills and a solutions-oriented attitude.
• Intermediate keyboard skills (typing, computer entry). Ability to work with multiple system applications simultaneously.

Salary Range

$41,472 - $76,032

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

• comprehensive benefits package
• various incentive programs/plans
• 401k contribution programs/plans

Department

Risk Adjustment

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of theCompany to provide equal employment opportunities to allqualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.