Records Retrieval Specialist

🕒 October 1

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

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 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

🎯 Requirements

• 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

🏖️ Benefits

• 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