Reporting - Medical Records Retrieval Specialist 135-1009 at CommunityCare

Tulsa, Oklahoma, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Oct, 26

Salary

0.0

Posted On

11 Jul, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Records Retrieval, EMR/EHR Systems, Risk Adjustment, HEDIS, Data Organization, Compliance, Microsoft Office, Adobe PDF, Communication, Problem Solving, Critical Thinking, Attention To Detail, Confidentiality, Record Retention, Provider Relations, Data Abstraction

Industry

Insurance

Description

JOB SUMMARY: The Medical Records Retrieval Specialist is responsible for requesting, collecting, organizing, and processing medical records to support Risk Adjustment, HEDIS, and Quality Improvement initiatives. This role manages all outbound and inbound record requests, retrieves documentation from provider offices and EMR/EHR systems, and ensures accurate, timely, and compliant handling of sensitive health information. The specialist works closely with the Risk Adjustment Supervisor and collaborates with provider groups through fax, phone, and occasional on-site visits. This position is office based with some travel required. KEY RESPONSIBILITIES: • Submit, track, and follow up on medical record requests. • Ensures the medical records are organized, accurate, and complete. • Maintain compliance with record retention and destruction policies. • Retrieve records from EMR/EHR systems such as EPIC, Cerner, and other provider platforms. • Scan, upload, and process inbound records received via fax, mail room, or electronic systems. • Support Risk Adjustment/RADV Audits, HEDIS, and Quality Improvement record collection projects. • Track, abstract, and organize member health records during audit seasons. • Assist with ad hoc audit requests and special retrieval projects. • Create, maintain, and update a centralized provider repository containing contact details, access instructions, retrieval notes, and historical performance. • Communicate with provider groups regarding record requests, status updates, and follow ups. • Update provider contact information (fax numbers, phone numbers) as needed. • Maintain clear documentation of all retrieval activities in chase reports. • Notify the supervisor of any issues or delays affecting record retrieval. • Meet daily and weekly productivity goals set by the supervisor. • Develops process workflows, escalation pathways, and standardized call scripts to support efficient and consistent operations. • Performs other job-related duties as assigned. QUALIFICATIONS: • Effective communication and collaboration abilities. • Excellent problem-solving and critical thinking skills. • Strong attention to detail and organizational skills. • Ability to maintain confidentiality and handle sensitive information. • Ability to maintain records and comply with retention policies. • Proficiency with Microsoft Office and Adobe PDF. • Successful completion of Health Care Sanctions background check. EDUCATION/EXPERIENCE: • High school diploma or 2+ years of experience in a similar role. • Medical office experience preferred. • Risk adjustment & HEDIS experience preferred. • Basic knowledge of EMR/EHR systems with ability to learn new software quickly. CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

Responsibilities

Responsible for requesting, collecting, and processing medical records to support Risk Adjustment, HEDIS, and Quality Improvement initiatives. The role involves managing record requests via EMR/EHR systems and maintaining a centralized provider repository.