Risk Adjustment Records Retrieval Architect

MetroPlus; New York (NY); On-site; USD 65,000 - 90,000; Full time

Job summary

MetroPlus on-site in New York seeks a Risk Adjustment Medical Record Retrieval Specialist to lead retrieval efforts, liaison with facilities and vendors, and build digital filing systems. You will access EHR, drop-box, eFAX, and email platforms, ensure data integrity, and use HIT standards to classify charts and validate encounters.

The role requires a Bachelor’s in health information administration or HIT and 3 years in a health plan or provider setting, with strong communication and analytical

Qualifications

• Bachelor's degree in health information administration or HIT, plus 3 years experience.
• HIT program approved by AHIMA or CAHIIM preferred.
• Experience with health plans or medical providers.

Responsibilities

• Establish and maintain ongoing contact with medical facilities and retrieval vendors to facilitate record retrieval.
• Create systems for categorizing and organizing medical records for long-term digital storage.
• Plan and execute retrieval projects, including identifying high-volume sites and setting retrieval goals.
• Access EHR systems, remote drop-boxes, electronic fax, and email to retrieve and save medical records.
• Apply HIT standards to identify proper chart types and valid encounters.
• Use data elements (date of service, provider type, demographics) to validate provider visits and request corrections if needed.
• Coordinate transmission of medical records across partners while ensuring documentation integrity and identifying gaps for complete chart reviews.
• Use analytics software (e.g., Excel, MySQL) to analyze retrieval project results and inform future designs.
• Identify acceptable stand-alone documentation and evaluate supporting documentation for validation of risk adjustment diagnoses.

Skills

Attention to detail

Communication skills

Analytical mindset

Education

Bachelor's degree in health information administration or HIT

Tools

Excel

MySQL

Job description

MetroPlus on-site in New York seeks a Risk Adjustment Medical Record Retrieval Specialist to lead retrieval efforts, liaison with facilities and vendors, and build digital filing systems. You will access EHR, drop-box, eFAX, and email platforms, ensure data integrity, and use HIT standards to classify charts and validate encounters.

The role requires a Bachelor’s in health information administration or HIT and 3 years in a health plan or provider setting, with strong communication and analytical