Senior Medical Record Retrieval Ops Specialist

This position supports the enterprise risk adjustment team with primary accountabilities related to quality improvement, Medical Records Review (MRR), and provider outreach and relations. This position will coordinate and implement activities supporting accurate and timely document management and retrieval efforts, adherence to regulatory and project timelines, improved delivery of clinical care, and protection of PHI. This position collaborates with multiple stakeholders at many levels across the company, as well as with external entities, providing coordination and support as required.

• Coordinate and track process flows for the Enterprise Risk Adjustment Medical Records. Review initiatives, ensuring process timeliness, information accuracy, and compliance with processes to protect PHI. This includes managing requests and documents such as Medical Records and Release-of-Information, as well as providing contributions to the production of an accurate, validated final audit result reporting.
• Assist quality assurance team and providers to troubleshoot any logistical or technical issues regarding records requests and management.
• Manage and implement communications processes for the annual HEDIS Medical Records Review initiative including clinic information updates, committee reports, article submissions, and distribution of communication materials to providers, ensuring adherence with challenging project timelines. This will include direct outreach to provider clinics to develop relationships and update information.
• Participate in clinical quality improvement projects, including implementation and execution of interventions such as member mailing campaigns, the distribution of provider materials, and other activities as required for project success.
• Manage and maintain Medical records repository for the Enterprise Risk Adjustment department. Ensure accuracy, timeliness of record uploads, compliance with processes to protect PHI, and effective tracking of records and record requests.
• Assume a key role in the development of new processes and tracking systems to support best practice record keeping and document management procedures. Coordinate and tracks process flows for received complaints, ensuring compliance with regulatory deadlines, protection of PHI, and reliable follow up. Identify process issues and contribute to the design of solutions. Proactively implement process improvements.
• Complete additional tasks as required to coordinate activities for and/or implement improvements to the quality of clinical care or to processes supporting the measurement of clinical quality.

• Associate's degree.
• RHIT Certification.
• Health Care or Health Plan experience.
• Experience with Medical Records or in a Clinical setting.
• Experience in using Adobe Pro.
• Experience in using Microsoft Access.
• Experience in using multiple software programs to complete a process.

• 5+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Related experience may be in roles involving coordination, organizing documents and/or information, tracking data or processes.
• Team player orientation with ability to build and maintain relationships with cross-functional business partners, external partners, and others.
• Highly developed diplomatic and interpersonal communication skills.
• Strong organizational skills, ability to prioritize responsibilities with attention to detail.
• Must be self-motivated, able to take initiative, and work independently with minimal oversight to meet timelines.
• Strong follow-through skills and a solutions oriented attitude.
• Detail oriented, with the ability to organize and track information and documents, to prioritize and maintain timelines, and to improve processes.
• Ability to work at a fast pace under pressure, meeting multiple deadlines and in multiple systems simultaneously.
• Experience in using Microsoft Excel and Word, and demonstrated ability to learn/adapt to computer based tracking and data collection tools.

Compensation and Benefits:

Pay Range: $23.10 - $28.88 - $34.66 Hourly

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.