Remote Medical Records Retrieval Specialist

Humana; United States; Remote; USD 42,000 - 66,000; Full time

Job summary

Humana is seeking a Medical Records Retrieval Specialist to conduct quality assurance audits, retrieve and validate medical records, and ensure accurate documentation for CMS and other agencies. This remote role requires travel to provider offices within Smyth County, VA area and surrounding counties, reporting to the Risk Adjustment Supervisor.

The position emphasizes accuracy, compliance, and efficiency to support positive member and provider outcomes, with normal hours Mon-Fri 8:00 am–5:00 pm

Qualifications

• 1+ year of experience in customer service.
• 1+ year of experience handling medical records.
• Proficient with Microsoft 365 (Teams, Outlook) for daily coordination.
• Experience managing high-volume workloads with professional standards.
• Knowledge of HIPAA regulations and privacy requirements.
• Healthcare/managed care exposure preferred.

Responsibilities

• Accurately collect, validate, and reconcile medical records with provider signatures.
• Upload verified docs to Cotiviti repository while preserving data integrity.
• Adhere to HIPAA, state/federal laws, and internal policies in handling PHI.
• Efficiently manage high-volume workload with minimal rework.
• Communicate with physician offices via high-volume calls and emails to obtain records.
• Travel up to 75% as needed and maintain safe driving practices.

Skills

Customer service

Medical records

HIPAA compliance

Communication

Attention to detail

Health care experience

Driver's license

Tools

Microsoft 365

Teams

Outlook

EMR systems

Job description

Humana is seeking a Medical Records Retrieval Specialist to conduct quality assurance audits, retrieve and validate medical records, and ensure accurate documentation for CMS and other agencies. This remote role requires travel to provider offices within Smyth County, VA area and surrounding counties, reporting to the Risk Adjustment Supervisor.

The position emphasizes accuracy, compliance, and efficiency to support positive member and provider outcomes, with normal hours Mon-Fri 8:00 am–5:00 pm