Medical Record Retrieval Specialist
Medical Record Retrieval Specialist - Bullhead Market Location: Remote Arizona (MUST reside within Arizona and within a two-hour commute of the Bullhead, AZ marketplace.) Full time The Medical Records Retrieval Specialist conducts quality assurance audits of medical records and diagnosis codes and measures submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. This is a remote role with field‑based responsibility, requiring some travel to provider offices to retrieve, review, and validate medical records on‑site. Scheduled Hours:
- The normal business hours for this position are Monday – Friday from 8:00 am – 5:00 pm PST
- Occasional schedule flexibility may be required to support business needs.
Duties and Responsibilities
- You will review and analyze medical records to ensure diagnosis codes are accurately supported by clinical documentation.
- Manage top priorities while maintaining a consistent level of organization, follow up, and a high standard of professional conduct.
- Conduct quality assurance audits with predefined health measures for CMS and other government agencies.
- Interpret and apply departmental procedures to complete assignments with accuracy.
- Independently manage workload tasks within defined service level expectations.
- Identify discrepancies in documentation and take appropriate action to resolve.
- Support provider-facing education efforts related to documentation and coding accuracy, as needed.
- Maintain strict confidentiality and safeguard protected health information (PHI) in compliance with HIPAA guidelines.
Travel Requirements:
- MUST reside within Arizona and within a two-hour commute of the Bullhead, AZ marketplace.
- Ability to travel up to 40% of the time at peak season, as needed.
- Must have reliable transportation.
Required Qualifications
- 1 or more years of customer service experience.
- 1 or more years with medical records.
- Experience using Microsoft Teams and Outlook.
- Strong written and verbal communication skills with the ability to clearly articulate information to internal stakeholders and external partners.
- Knowledge and experience in health care environment/managed care (provider office, billing, coding, release of information, etc.)
- This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individuals must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
Preferred Qualifications
- Bachelor's degree in a related field.
- Knowledge or experience in health care environment/managed care.
- Knowledge of ICD-9/10 codes.
- Knowledge of medical terminology.
- Experience and comfort with EMR systems.
Additional Information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Apply tot his job Apply To this Job