Medical Records Coordinator II (Hybrid/Springfield MA Office)

CareSource; Springfield (MA); Hybrid; USD 49,456,000 - 78,936,000; Full time

Job summary

CareSource in Springfield, MA is seeking a Medical Records Coordinator II to handle retrospective medical record retrieval, ROI deployment, data analysis, and documentation. This hybrid role requires one day per week in the Springfield office and remaining days remote.

You will collaborate with health systems, maintain records, verify accuracy, and support risk adjustment processes across lines of business. Strong MS Office skills and healthcare experience preferred.

Qualifications

• High School Diploma or equivalent required.
• Minimum one (1) year healthcare experience required.
• Minimum one (1) year medical records experience required.
• Minimum one (1) year EHR/EMR experience required.

Responsibilities

• Execute the request, retrieval, and pend resolution of medical records through various channels.
• Utilize MS Office Suite (including MS Teams, Office, Excel, Outlook, Word) to facilitate record retrieval.
• Verify retrieved medical records’ accuracy.
• Collaborate with health systems and provider offices to document release of information processes.
• Populate chase specific reports and support risk adjustment processes across lines of business.

Education

High School Diploma or equivalent

Job description

Job Summary

The Medical Records Coordinator II is responsible for all forms and aspects of retrospective medical record retrieval including, but not limited to, claims data analysis, outreach data research, direct EMR retrieval, Requests of Information (ROI) deployment, pend-record resolution, medical record audits, attestation capture, and report documentation. This is a hybrid position, working 1 day per week in the Springfield MA office and other days remote.

Essential Functions

• Execute the request, retrieval, and pend resolution of medical records through various channels
• Utilize custom and SFTP portals to facilitate PHI data transfer
• When needed provide personal information necessary to gain access to health network systems
• Collaborate with health systems and provider offices to execute, and document their process for release of information requests
• Update operational databases, and provide context by documenting commentary
• Navigate and properly escape obstacles to medical record retrieval
• Support and implement process improvements with external and internal partners
• Utilize the MS Office Suite including, but not limited to MS Teams, Office, Excel, Outlook, and Word to facilitate record retrieval and execute mail merges
• Verify retrieved medical records’ accuracy
• Partner across CareSource’s department matrix to address operational needs
• Support and maintain medical record repository
• Manage provider practice and health network relations to minimize provider abrasion
• Populate chase specific reports to drive and reflect the execution of risk adjustment programs
• Support and refine implementation of risk adjustment processes across all lines of business
• Research claims data to produce information optimized for chart retrieval
• Reconcile retrieval related invoices
• Perform any other job duties as requested

Education and Experience

• High School Diploma or equivalent required
• Minimum one (1) year healthcare experience required
• Minimum one (1) year medical records experience required
• Minimum one (1) year EHR/EMR experience required

Competencies, Knowledge and Skills

• Intermediate proficiency in the Microsoft Office Suite
• Verbal and written communication skills
• Ability to work independently and within a team environment
• Attention to detail
• Critical listening and thinking skills
• Time management skills
• Proper phone etiquette
• Data analysis
• Business analysis
• Project management
• Customer service oriented
• Brand ambassadorship
• Decision making/problem solving skills
• Takes initiative to research and resolve obstacles
• Must be able to self-direct work when given a goal/task

Licensure and Certification

None

Working Conditions

General office environment; may be required to sit or stand for extended periods of time May be required to travel

Compensation Range

$35,900.00 - $57,300.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type

Hourly

Organization Level Competencies

• Fostering a Collaborative Workplace Culture
• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time.

CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-SD1 Brand=Commonwealth Care Alliance

The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.