Medical Records Specialist Hybrid
Location: Midtown New York
Pay: $24.00 – $27.00/hour
We are seeking an experienced Medical Records Specialist to support our Risk Adjustment and Quality initiatives. The ideal candidate will have hands-on experience retrieving medical records from providers via phone, fax, EMR connectivity, email, and onsite visits. This role involves organizing, tracking, and safeguarding records, as well as educating providers on compliance requirements. The Specialist works under limited supervision and may provide guidance to other staff members.
Key Responsibilities
Retrieve medical records from providers’ offices, clinics, and healthcare facilities through multiple channels (phone, fax, email, EMR, onsite).
Perform initial screenings of medical records to ensure Risk Adjustment eligibility (Medicare, Medicaid, Commercial Health Plan).
Manage, organize, and maintain records in a central repository (data entry, scanning, naming conventions).
Track retrieval progress and follow up on outstanding requests; escalate unretrievable records as needed.
Schedule and perform onsite medical record reviews with high-volume providers for HEDIS/QARR and related audits.
Evaluate documentation discrepancies and advise providers on corrective actions.
Enter findings into databases and prepare reports as required.
Safeguard patient information and ensure HIPAA compliance at all times.
Educate providers and office staff on CMS guidance and medical record criteria.
Participate in training, audits, surveys, and focused studies.
Provide related administrative support and assist with improvement of record management processes.
Qualifications
Minimum 2 years of experience in medical record retrieval and review required.
Minimum 1 year of Risk Adjustment experience in Medicare, Medicaid, or Commercial Health Plans preferred.
Strong knowledge of HEDIS/QARR standards and Risk Adjustment processes.
Ability to review and evaluate medical records with accuracy and attention to detail.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Access).
Strong organizational skills with the ability to multitask and troubleshoot independently.
Excellent verbal and written communication skills; strong interpersonal abilities.
Working knowledge of HIPAA and healthcare confidentiality standards.
Resumes to mfesinstine@phaxis.com
#Phaxis.com
An Equal Employment Opportunity Employer
