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Records Retrieval Specialist - Kannapolis, North Carolina

Remote · USA Full-time New today

Humana is a leading U.S. healthcare company seeking a Medical Records Retrieval Specialist. This role involves conducting quality assurance audits of medical records and ICD-9/10 diagnosis codes, requiring travel to provider offices to retrieve and validate medical records on-site.

Responsibilities

  • Collect medical records and conduct research to ensure accuracy of member information and obtain provider signatures
  • Upload verified documents to Cotiviti centralized repository
  • Follow state and federal regulations as well as internal policies and guidelines while retrieving medical records
  • Interpret and apply departmental procedures to complete assignments with accuracy and efficiency
  • Use a laptop computer and a portable scanner and encrypted flash drive to retrieve medical records which will be uploaded into a database
  • Conduct a high volume of calls to physician offices by phone and email to efficiently meet all deadlines
  • Maintain strict confidentiality and safeguard protected health information (PHI) in compliance with HIPAA guidelines
  • Independently manage workload within defined service level expectations

Skills

  • 1 or more years of customer service experience
  • 1 or more years with medical records
  • Use Microsoft Teams and Outlook daily to coordinate meetings, manage calendars, and support internal communication
  • Experience handling a high volume of tasks and follow up and maintaining a high standard of professional conduct
  • Experience articulating information to internal peers and external partners
  • Knowledge or experience in health care environment/managed care (provider office, billing, coding, release of information, etc.)
  • This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individuals must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher
  • Associate's degree or higher in a related field
  • 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

Benefits

  • Medical, dental and vision benefits
  • 401(k) retirement savings plan
  • Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • Short-term and long-term disability
  • Life insurance
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Company Overview

  • Humana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is http://www.humana.com.
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