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