Risk Adjustment Medical Record Retrieval Specialist

Job Ref: TE0196
Category: Professional
Department: ANALYTICS AND REPORTING
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Work Arrangement: Hybrid
Salary Range: $72,000.00 - $82,000.00

Position Overview

The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to improve the retrieval of medical records for our risk adjustment program. You will establish and maintain contact with medical facilities and retrieval vendors to achieve success and accuracy in the retrieval or targeted medical records. You must have strong attention to detail and a knack for creating systems to store and organize records digitally. You will need to obtain access and retrieve records from a variety of digital platforms, including EHR systems and remote drop-boxes, as well as digital fax and e-mail. Strong communication skills are a must in order to maintain collaborative relationships with medical facilities and our retrieval vendors.

Scope of Role & Responsibilities

• Establish and maintain ongoing contact with medical facilities. Triage issues at each facility in order to facilitate the retrieval of records.
• Create systems or categorizing and organizing medical records for long-term digital storage.
• Create and execute plans for specific retrieval projects, including identifying high-volume sites, setting retrieval goals and working with internal staff and external vendors to achieve retrieval goals.
• Access various retrieval systems, including remote EHR systems, electronic drop-box and eFAX systems to retrieve and save medical records.
• Use Health Information Technology (HIT) standards to identify proper chart types and valid encounters.
• Use various data elements (incl. date of service, provider type, demographic information, etc) to validate provider visits. Work with facilities to request corrected medical records when necessary.
• Coordinate the transmission of medical records across various partners while ensuring documentation integrity through the identification of gaps necessary for a complete chart review.
• Use analytic software (i.e. Excel or MySQL) to analyze the results of retrieval projects – draw conclusions and insights from data to help inform the design of future projects.
• Identifies acceptable stand-alone documentation and evaluates supporting or supplemental documentation used to validate risk adjustment diagnoses and findings. Reviews the documentation for chart deficiencies and completeness.

Required Education, Training & Professional Experience

• Bachelor's degree required, preferably in health information administration (HIA) or health information technology (HIT); and three (3) years of experience working at a health plan or medical provider/facility.
• Medical record technology or health information technology (HIT) program approved by a nationally accredited agency (e.g., AHIMA or CAHIIM) preferred.

Professional Compentencies 

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication

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