Medical Record Retrieval Specialist

🔥 14 hours ago

🌵 Arizona, Florida, +15 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🌾 Nebraska – Remote 🌾 North Dakota – Remote 🌪️ Oklahoma – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote

💵 $41.3k - $70.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Medica

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1975

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Medica is a nonprofit health plan and insurer with over 50 years of experience that provides individual & family plans, Medicare, Medicaid, and employer-provided health plans. It offers member services and tools for finding providers, managing benefits and claims, wellness programs, and community-focused initiatives through the Medica Foundation to advance health equity.

📋 Description

• Request and retrieve medical records from provider offices, health systems, vendors, and EHR platforms using phone, email, fax, portals, and approved systems • Support HEDIS Hybrid Reviews, CMS Cost Audits, RADV, Data Validation, and other clinical or audit reviews • Follow retrieval timelines, protocols, and escalation processes • Identify and escalate missing, incomplete, or delayed records • Review records for completeness, legibility, required date ranges, and relevance • Identify documentation gaps and coordinate follow-ups with providers • Validate records against audit and project requirements • Partner with clinical reviewers, auditors, and data teams to clarify documentation needs • Upload, index, and organize records in designated systems such as SharePoint and internal audit tools • Maintain accurate file naming, version control, record association, and real-time retrieval tracking • Perform quality checks to ensure records are audit-ready • Serve as a point of contact for providers regarding record requests and submissions • Provide status updates to internal stakeholders • Document outreach and escalation activities • Handle PHI in accordance with HIPAA, CMS, and organizational policies • Use approved secure methods for record transmission and storage • Perform other assigned duties

🎯 Requirements

• High school diploma or equivalent experience • 2 years of experience in medical record retrieval, healthcare operations, clinical support, or related field • Proficiency with Adobe Acrobat • Proficiency with Microsoft Office, including Outlook, Excel, SharePoint, and Teams • Must have a primary home address in a state where Medica is registered as an employer: Arkansas, Arizona, Florida, Georgia, Iowa, Illinois, Kansas, Kentucky, Michigan, Minnesota, Missouri, North Dakota, Nebraska, Oklahoma, South Dakota, Tennessee, Texas, Virginia, or Wisconsin • Must be legally authorized to work in the United States at the time of application • Medica does not offer work visa sponsorship • Excellent verbal and written communication skills • Strong organizational and time-management skills • Ability to manage multiple priorities independently • Experience with HEDIS, CMS Cost Audits, RADV, or other regulatory audits preferred • Familiarity with EHR systems such as Epic and Cerner preferred • Experience working with provider offices or HIM departments preferred • Knowledge of healthcare quality measures or regulatory documentation standards preferred • Associate degree or higher in Health Information Management or related field preferred

🏖️ Benefits

• Competitive medical, dental, and vision benefits • PTO • Paid holidays • Paid volunteer time off • 401(k) contributions • Caregiver services • Other total rewards benefits