Records Retrieval Specialist

🕒 il y a 23 jours

⚔️ Virginia – Distant

infoinfo

💵 $40 000 - $52 300 / an

⏰ Temps Plein

🟢 Junior

🚫👨‍🎓 Aucun diplôme requis

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Humana

Humana

10 000+ employés

Fondée en 1961

🏥 Santé

🛡️ Assurance

⚕️ Assurance santé

Healthcare • Insurance • Healthcare Insurance

Humana est une entreprise de soins de santé dédiée à avoir un impact positif sur la santé des individus, des communautés et du système de santé dans son ensemble. En mettant la santé au premier plan, Humana sert une large gamme de populations diverses, y compris les seniors et les militaires, en proposant des plans Medicare Advantage HMO, PPO et PFFS. Humana s'engage à favoriser une culture d'appartenance et de respect mutuel, offrant des avantages compétitifs et flexibles pour assurer la sécurité financière de ses employés et de leurs familles. L'entreprise est fière de créer un environnement de travail inclusif où chacun a l'opportunité de réussir.

Description

• Conduct quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to CMS and other government agencies • Retrieve, review, validate, and reconcile medical records at provider offices • Obtain required provider signatures • Upload verified documentation to the Cotiviti centralized repository • Maintain data integrity and quality standards • Comply with state and federal regulations, HIPAA requirements, and internal policies • Use company-issued technology to securely retrieve and manage medical records • Conduct high-volume phone and email outreach to physician offices • Maintain confidentiality and safeguard PHI • Manage a high-volume workload independently while meeting productivity, quality, and service-level expectations • Travel up to 75% and occasionally stay overnight • Report directly to the Risk Adjustment Supervisor

🎯 Exigences

• Reside within Smyth County, VA or bordering counties: Russell, Tazewell, Bland, Wythe, Grayson, or Washington counties • 1 or more years of experience in customer service • 1 or more years of experience with medical records • 1 or more years of experience using Microsoft 365 and associated applications, such as Teams and Outlook daily • Experience managing high-volume workloads while ensuring prompt follow-up and adherence to professional standards • Experience articulating information to internal peers and external partners • Experience in health care environment/managed care • Valid state driver's license • Reliable transportation • Personal vehicle liability insurance meeting applicable requirements • Knowledge or experience in health care environment/managed care • Knowledge of ICD-9/10 codes • Knowledge of medical terminology • Experience and comfort with EMR systems • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Avantages

• Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Company-issued laptop, portable scanner, and encrypted storage devices • Remote work arrangement • Home office work setup with dedicated space • Travel to Humana offices for training or meetings may be required

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