Remote Records Retrieval Specialist – Risk Adjustment

Humana; Virginia; Remote; USD 40,000 - 52,000; Full time

Job summary

Humana is seeking a Records Retrieval Specialist (Risk Adjustment Rep. 2) to perform quality assurance audits of medical records and ICD-9/10 codes in a remote, field-based role serving the Northern Virginia area.

Travel to provider offices is required to retrieve, review, and validate records on-site under the supervision of the Risk Adjustment Supervisor. The role emphasizes accuracy, compliance, and efficiency, with expectations to securely handle PHI and maintain data integrity while

Qualifications

• 1+ year of customer service experience.
• 1+ year of experience with medical records.
• 1+ year of using Microsoft 365 (Teams/Outlook) daily.
• Experience managing high-volume workloads with prompt follow-up.
• Ability to articulate information to internal peers and external partners.
• Experience in a healthcare environment/managed care.
• Must have a valid state driver's license and vehicle insurance per company policy.

Responsibilities

• Accurately collect, validate, and reconcile medical records to ensure complete member information and obtain required signatures.
• Upload verified documentation to the Cotiviti centralized repository with data integrity and quality.
• Adhere to state/federal regulations, HIPAA, and internal policies when handling medical records.
• Apply departmental procedures to complete assignments accurately, efficiently, and with minimal rework.
• Utilize laptops, portable scanners, and encrypted storage to securely retrieve and manage medical records.
• Proactively contact physician offices via high-volume phone and email outreach to obtain records and meet deadlines.
• Maintain strict confidentiality and safeguard PHI at all times.
• Manage a high-volume workload independently while meeting productivity, quality, and service-level expectations.

Skills

Customer service

Medical records

Microsoft 365

High-volume work

Communication skills

Healthcare experience

Driver's license

Tools

EMR systems

Job description

Humana is seeking a Records Retrieval Specialist (Risk Adjustment Rep. 2) to perform quality assurance audits of medical records and ICD-9/10 codes in a remote, field-based role serving the Northern Virginia area.

Travel to provider offices is required to retrieve, review, and validate records on-site under the supervision of the Risk Adjustment Supervisor. The role emphasizes accuracy, compliance, and efficiency, with expectations to securely handle PHI and maintain data integrity while