Conduct quality assurance audits of medical records and ICD‑9/10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS)
Collect medical records and conduct research to ensure accuracy of member information and obtain provider signatures
Upload verified documents to Cotiviti centralized repository within 24-hour time frame
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, a portable scanner, and encrypted flash drive to retrieve medical records
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

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 communicate with supervisor and peers
Experience handling a high volume of tasks and follow up
Experience articulating information to internal peers and external partners
Knowledge or experience in a health care environment/managed care (provider office, billing, coding, release of information, etc.)
A valid state driver's license and are expected to maintain personal vehicle liability insurance

Records Retrieval Specialist

Key skills