Records Retrieval Specialist

🔥 13 hours ago

🌴 South Carolina – Remote

🌴 South Carolina – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Conduct quality assurance audits of medical records and ICD‑9/10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies • Collect medical records and conduct research to ensure accuracy of member information and obtain provider signatures • Upload verified documents to Cotiviti centralized repository within 24-hour time frame • Follow state and federal regulations as well as internal policies and guidelines while retrieving medical records • Independently manage workload within defined service level expectations • Travel for up to 60% of the time to provider offices to retrieve, review, and validate medical records on‑site

🎯 Requirements

• 1 or more years of customer service experience • 1 or more years with medical records • Use Microsoft Teams and Outlook daily to coordinate meetings, manage calendars, and communicate with supervisor and peers • Experience handling a high volume of tasks and follow up and maintaining a high standard of professional conduct • Experience articulating information to internal peers and external partners • Knowledge or experience in a health care environment/managed care (provider office, billing, coding, release of information, etc.) • Must have a valid state driver's license and are expected to maintain personal vehicle liability insurance

🏖️ Benefits

• Medical, dental and vision benefits • 401(k) retirement savings plan • Time off (including paid time off, company and personal holidays, paid parental and caregiver leave) • Short-term and long-term disability • Life insurance and many other opportunities