What are the responsibilities and job description for the Medical Record Retrieval Specialist position at Medical Mutual?
The Medical Record Retrieval Specialist position allows you the flexibility to work at home as long as you reside within a 50-mile radius of a local Medical Mutual office.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.
Medical Mutual' s status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us and help our members achieve their best possible health and quality of life.
Responsibilities
Medical Record Retrieval Specialist
Supports the company's risk adjustment projects by collaborating with vendors and provider offices / facilities to retrieve medical records. Supports other initiatives related to Risk Adjustment Programs (RAPS) and Healthcare Effectiveness Data and Information Set (HEDIS) while adhering to HIPAA guidelines.
- Supports chart retrieval activities for projects related to RAPS and HEDIS efforts. Works closely with providers and other quality team members, Health Informatics, IT and vendor partners. Researches and identifies issues / barriers in effort to maximize successful chart retrieval projects. Retrieves medical records from a variety of systems including, but not limited to, provider Electronic Medical Record (EMR) systems (i.e. EPIC). Maintains professional relationships with providers to ensure successful and timely chart retrieval while consistently adhering to HIPPA guidelines to ensure privacy during the retrieval process.
- Participates on cross functional teams that develop education and incentive programs for providers related to RAPS, STARS and HEDIS. Collaborates closely with Provider Engagement, Provider Network Performance, and Health Informatics in planning and delivery of reports to close coding and care gaps and improve member outcomes.
- Reviews incoming medical records to validate the accuracy and integrity of the data. Ensures all documents are scanned and indexed in a timely and efficient manner.
- Partners with internal departments on ad hoc initiatives and projects, and performs other duties as assigned.
- Assists in maintaining database containing providers' chart retrieval preferences to support successful and optimal chart retrieval projects.
- Performs other duties as assigned.
Sr. Medical Record Retrieval Specialist
Under limited supervision, supports the company's risk adjustment projects by collaborating with vendors and provider offices / facilities to retrieve medical records. Serves as the main point of contact and project lead for large provider groups. Supports other initiatives related to Risk Adjustment Programs (RAPS) and Healthcare Effectiveness Data and Information Set (HEDIS) while adhering to HIPAA guidelines. Orients, trains and assists more junior level staff. Makes recommendations for process improvement and participates in special projects as needed.
Medical Record Retrieval Specialist
Education and Experience :
Professional Certification(s) :
Technical Skills and Knowledge :
Sr. Medical Record Retrieval Specialist
Education and Experience :
Professional Certification(s) :
Technical Skills and Knowledge :
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes :
A Great Place to Work :
Excellent Benefits and Compensation :
An Investment in You :
About Medical Mutual :
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Salary : $5,250
