Remote Records Retrieval Specialist (Risk Adjustment)

Humana, Inc.; Virginia; À distance; USD 40 000 - 52 000; Plein temps

Avantages offerts par ce poste

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Résumé du poste

Humana, Inc. is seeking a Records Retrieval Specialist to perform quality assurance audits of medical records and ICD-9/10 codes for CMS and other agencies.

This remote role requires travel to provider offices within Northern Virginia to retrieve and verify records on-site, reporting to the Risk Adjustment Supervisor. The role emphasizes accuracy, compliance, and efficiency, with daily use of Microsoft 365 tools, and strict PHI protection.

Qualifications

• 1+ years of experience in customer service.
• 1+ years of experience with medical records.
• 1+ years of experience using Microsoft 365 (Teams and Outlook).
• Experience managing high-volume workloads with prompt follow-up.
• Experience articulating information to internal and external partners.
• Experience in health care environment/managed care.

Responsabilités

• Accurately collect, validate, and reconcile medical records and obtain required provider signatures.
• Upload verified documentation to the Cotiviti centralized repository with data integrity.
• Adhere to HIPAA and internal policies when handling medical records.
• Proactively contact physician offices via phone and email to obtain records and meet deadlines.

Connaissances

Customer service

Medical records

Microsoft 365

Communication skills

High-volume workload

Healthcare environment

Driver's license

Formation

None

Outils

EMR systems

Description du poste

Humana, Inc. is seeking a Records Retrieval Specialist to perform quality assurance audits of medical records and ICD-9/10 codes for CMS and other agencies.

This remote role requires travel to provider offices within Northern Virginia to retrieve and verify records on-site, reporting to the Risk Adjustment Supervisor. The role emphasizes accuracy, compliance, and efficiency, with daily use of Microsoft 365 tools, and strict PHI protection.