Remote Records Retrieval & Compliance Specialist

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

Benefits offered by this job

Medical coverage

Dental & Vision

401(k)

Paid time off

Parental leave

Job summary

Humana is seeking a Records Retrieval Specialist (Risk Adjustment Rep. 2) for a remote role with extensive field duties in Northern Virginia. Travel to provider offices is required to retrieve, review, and validate medical records, reporting to the Risk Adjustment Supervisor.

Responsibilities include collecting and reconciling records, uploading documents, and maintaining HIPAA compliance while meeting deadlines and quality standards.

Qualifications

• 1+ years of customer service experience.
• 1+ years of experience with medical records.
• 1+ years of using Microsoft 365 including Teams and Outlook.
• Experience handling high-volume workloads with prompt follow-up.
• Ability to articulate information to internal and external partners.
• Experience in health care/managed care settings.

Responsibilities

• Accurately collect, validate, and reconcile medical records, ensuring required signatures.
• Upload verified documentation to Cotiviti repository with data integrity.
• Adhere to HIPAA and all state/federal regulations during retrieval and handling of PHI.
• Follow departmental procedures to complete assignments accurately and efficiently.
• Use company devices to securely retrieve and manage medical records.
• Proactively contact physician offices via calls and emails to obtain records and meet deadlines.
• Maintain strict confidentiality and manage workload independently to meet productivity and quality targets.

Skills

Customer service

Medical records

Microsoft 365

High-volume workload

Communication

Healthcare environment

Tools

EMR systems

Outlook/Teams

Job description

Humana is seeking a Records Retrieval Specialist (Risk Adjustment Rep. 2) for a remote role with extensive field duties in Northern Virginia. Travel to provider offices is required to retrieve, review, and validate medical records, reporting to the Risk Adjustment Supervisor.

Responsibilities include collecting and reconciling records, uploading documents, and maintaining HIPAA compliance while meeting deadlines and quality standards.