Resp & Qualifications

PURPOSE: 
The Medical Record Retrieval Specialist will coordinate and implement activities supporting accurate and timely document management and retrieval efforts, adherence to regulatory and project timelines, and protection of the privacy of individuals' health information according to HIPAA. This role will perform outreach to provider offices to coordinate record retrieval efforts and maintain the provider contact database.

Note:  We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week

ESSENTIAL FUNCTIONS:

• Contacts provider offices with a high degree of professionalism and confidence to communicate expectations, charts required, etc. Establishes relationships with providers and ROI (Request of Information) vendors. Assists provider's offices with the process of sending medical records. Educates, trains, provides support to provider's staff on the different methods to send medical records. Analyzes and monitors progress of incoming correspondence including medical records to determine which organizations will need additional outreach. Identifies, investigates, and resolves issues related to incoming correspondence.
• Conducts provider outreach and research to locate contact information of medical providers that may be practicing, retired, or otherwise relocated. Updates and maintains the Provider Database. Communicates professionally with medical facilities, third party vendors, and Company stakeholders.
• Develops tracking and monitoring methods for medical record requests. Manages and maintains medical records repository. Ensures accuracy, timeliness of record uploads, compliance with processes to protect PHI, and effective tracking of records and record requests. Performs processing tasks such as: sorting incoming mail, preparing documents for scanning, retrieving information from Right Fax, and moving documents as appropriate to the repository or vendor platform. Retrieval of medical records via fax, mail, remote electronic medical record access or onsite visits at the provider location. Use computer systems and applications for data entry, edits, and information retrieval.
• Assumes a key role in the development of new processes and tracking systems to support best practice record keeping and document management procedures. Identifies process issues and contributes to the design of solutions. Proactively implements process improvements. Assists internal team and provider groups to troubleshoot any logistical or technical issues regarding record requests or retrieval.

QUALIFICATIONS:

Education Level: Associate's Degree in Healthcare Management, Business or related field OR in lieu of an Associate degree, an additional 2 years of relevant work experience is required in addition to the required work experience.

Experience: 3 years experience with insurance, managed care or healthcare organization

Knowledge, Skills and Abilities (KSAs)

• Experience in using Microsoft Office (Excel, Word, Power Point, etc.) and Adobe Pro and demonstrated ability to learn/adapt to computer-based tracking and data collection tools.
• Ability to effectively communicate (oral and written) and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
• Strong organizational skills, ability to prioritize responsibilities with attention to detail.
• Self-motivated, able to take initiative, and work independently with minimal oversight to meet timelines, strong follow-through skills and a solutions-oriented attitude.
• Intermediate keyboard skills (typing, computer entry). Ability to work with multiple system applications simultaneously.
• Highly developed interpersonal skills.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $39,096 - $71,676

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Risk Adjustment

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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