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DescriptionThe Medical Records Retrieval Specialist/ Risk Adjustment Representative 2 conducts quality assurance review of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies.How we Value YouBenefits starting day 1 of employmentCompetitive 401k matchGenerous Paid Time Off accrualTuition ReimbursementParent LeaveGo365 perks for well-beingResponsibilitiesMedical Records Retrieval Specialist/ Risk Adjustment Representative 2 requires 75% travel to provider offices in GeorgiaThe Medical Records Retrieval Specialist ensures accurate and properly supported clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines while analyzing medical records.Travel up to 75% of the time, and will consist of driving to locations close to your home, as well as driving to locations that require overnight travel for up to a week at a time.
Use a laptop computer and a portable scanner and encrypted flash drive to retrieve medical records which will be uploaded into a database.
Schedule appointments and visits to physician offices in a timely, efficient manner to meet all deadlines.
Required QualificationsWorking knowledge of healthcare environment/managed care (provider office, billing, coding, medical records)
Strong written and verbal communication skills; strong analytical, organizational and time management skills
Proficiency in Microsoft Office applications: Word and Excel
Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills including ability to learn new computer programs
Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload)
This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits
Ability to provide a designated workspace; free from distractions with the ability to secure any protected information.
Preferred QualificationsExperience in EMR (Electronic Medical Records) system
Additional InformationMonday-Friday hours range between 7am- 5pm
This position requires 75% travel to provider offices
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.Work-At-Home RequirementsWAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.Scheduled Weekly Hours40
