Retrieval Specialist / Provider Services Representative

Encore Talent Solutions; New Albany (OH); On-site; USD 42,000 - 65,000; Full time

Job summary

Encore Talent Solutions is seeking a Retrieval Specialist / Provider Services Representative to obtain complete medical records for health plan customers. You will work with AI-assisted outreach and human follow-through to manage requests, resolve barriers, and interact with providers to verify information and coordinate delivery.

The role requires attention to detail, strong communication, and the ability to balance multiple requests while maintaining confidentiality and compliance with privacy

Qualifications

• Experience in customer service or call-center operations.
• Ability to manage multiple assignments and prioritize follow-ups.
• Strong written and verbal communication; detail-oriented and able to work independently.

Responsibilities

• Obtain complete and accurate medical records from healthcare providers.
• Coordinate delivery methods and follow-up dates with provider offices.
• Resolve barriers in retrieval through research and escalation when needed.
• Maintain records of outreach, statuses, and next steps.
• Protect confidential information and comply with privacy requirements.
• Meet productivity and quality standards and contribute to workflow improvements.

Skills

Customer service

Communication

Problem-solving

Multitasking

Research

Education

High school diploma or equivalent

Tools

CRM systems

EMR/EHR access

MS Office / data-entry

Job description

Retrieval Specialist / Provider Services Representative

Overview

The Retrieval Specialist obtains complete and accurate medical records from healthcare providers on behalf of health plan customers. Working alongside AI-assisted outreach and automation, this role manages assigned requests, resolves retrieval barriers, and handles provider interactions requiring human judgment and follow-through.

Key Responsibilities

• Manage assigned medical-record requests from initial review through retrieval, approved handoff, or documented closure.
• Contact provider offices and record custodians to verify information, confirm record availability, coordinate delivery methods, and establish follow-up dates.
• Research inaccurate or missing provider information and resolve delayed, complex, or escalated requests.
• Review automated outreach history, follow AI-to-human handoff procedures, and avoid duplicate outreach.
• Manage pending requests, document unresolved barriers, and coordinate with research, EMR, intake, quality, and other retrieval teams.
• Maintain accurate records of outreach, commitments, research, statuses, and next steps.
• Protect confidential information and follow privacy, security, customer, and company requirements.
• Meet retrieval, quality, productivity, and schedule expectations while identifying opportunities to improve workflows.

Required Qualifications

• High school diploma or equivalent.
• Experience in customer service, call-center operations, healthcare administration, medical records, claims, provider relations, or a similar detail-oriented environment.
• Strong telephone communication, written documentation, research, and problem-solving skills.
• Ability to manage multiple assignments, prioritize follow-ups, and work independently and collaboratively.
• Basic proficiency with web-based applications, email, office tools, and data-entry systems.
• Ability to handle confidential information, follow procedures, and recognize when escalation is needed.

Preferred Qualifications

• Experience with medical-record retrieval, provider outreach, health plans, HEDIS, Risk Adjustment, IVA, or RADV.
• Familiarity with CRM, case-management, healthcare, or call-center systems.
• Knowledge of record-request methods, including fax, secure email, portals, mail, and EMR access.
• Experience with exception queues, escalations, automation, or AI-assisted workflows.