Medicare Risk Adjustment Chart Retrieval Specialist

Clever Care Health Plan; Huntington Beach (CA); Híbrido; USD 31 000 - 36 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Hybrid work schedule

On-site Huntington Beach office

Resumo da oferta

Clever Care Health Plan in California is seeking a Risk Adjustment Coordinator, Chart Retrieval, to oversee end-to-end medical record retrieval for the Medicare Advantage program. You will engage PCP offices, hospitals, and IPAs to collect complete records needed for HCC validation and audits.

Responsibilities include confirming record completeness, coordinating secure data transfer, and maintaining accurate logs while upholding HIPAA standards.

Qualificações

• High school diploma or equivalent required; associate or bachelor’s degree preferred.
• Experience with medical record retrieval, health information management, or risk adjustment.
• Experience communicating with PCP offices, medical groups, IPAs, or hospitals.
• Medicare Advantage or risk adjustment experience preferred.

Responsabilidades

• Coordinate chart retrieval requests from initiation through receipt and closure.
• Contact providers by phone, fax, secure email, or provider portal to obtain records.
• Validate retrieved records match member and service details for review.
• Maintain HIPAA-compliant handling and timely escalation of missing or incomplete records.
• Support RADV and audit activities with organized documentation.

Conhecimentos

Telephone communication

Written communication

Relationship management

Follow-up skills

Bilingual ability

Formação académica

High school diploma or equivalent

Associate or Bachelor's degree preferred

Ferramentas

Microsoft Outlook

Excel

Word

Teams

Electronic fax

Provider portals

Workflow systems

Document imaging tools

Descrição da oferta de emprego

Clever Care Health Plan in California is seeking a Risk Adjustment Coordinator, Chart Retrieval, to oversee end-to-end medical record retrieval for the Medicare Advantage program. You will engage PCP offices, hospitals, and IPAs to collect complete records needed for HCC validation and audits.

Responsibilities include confirming record completeness, coordinating secure data transfer, and maintaining accurate logs while upholding HIPAA standards.