Remote Medical Records Retrieval Specialist

Humana; Yorktown (VA); Remote; USD 40,000 - 52,000; Full time

Job summary

Humana is seeking a Medical Records Retrieval Specialist to conduct QA audits of medical records and ICD-9/10 codes for CMS and other government agencies. This remote role requires travel to provider offices around Smyth County, VA, reporting to the Risk Adjustment Supervisor.

You will collect, validate, and reconcile records, upload documentation to the Cotiviti repository, and ensure data integrity while maintaining PHI confidentiality and complying with regulations.

Qualifications

• 1+ years in customer service.
• 1+ years in medical records.
• 1+ years using Microsoft 365 (Teams/Outlook).
• Experience handling high-volume workloads.
• Experience communicating with internal/external partners.
• Healthcare/managed care experience.

Responsibilities

• Accurately collect, validate, and reconcile medical records with provider signatures.
• Upload verified documentation to Cotiviti repository with data integrity.
• Adhere to HIPAA and state/federal regulations when handling PHI.
• Use company devices to securely retrieve and manage records.
• Proactively reach out to physician offices to obtain records.
• Manage high-volume workload independently while meeting deadlines.

Skills

Customer service

Medical records

Microsoft 365 apps

Teams

Outlook

High-volume workload management

PHI confidentiality

Tools

EMR systems

Laptop

Portable scanners

Encrypted storage devices

Job description

Humana is seeking a Medical Records Retrieval Specialist to conduct QA audits of medical records and ICD-9/10 codes for CMS and other government agencies. This remote role requires travel to provider offices around Smyth County, VA, reporting to the Risk Adjustment Supervisor.

You will collect, validate, and reconcile records, upload documentation to the Cotiviti repository, and ensure data integrity while maintaining PHI confidentiality and complying with regulations.