Medical Record Retrieval Specialist Job Listing at Medical Mutual in OH (Job ID 2400643)

Description

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.

·    Supports chart retrieval activities for projects related to RAPS and HEDIS efforts.  Works closely with large provider groups to ensure the best retrieval outcomes for each project.  Also works closely with other quality team members, Health Informatics, IT and vendor partners. Researches and identifies issues/barriers and offers suggestions to overcome the barriers. 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.

·    Serves as subject matter expert on chart retrieval projects related to RAPS.  Assist in coordinating and implementing activities that support accurate, successful, and timely retrieval efforts.  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. 

·    Partners with internal departments on ad hoc initiatives and projects.

·    Reviews incoming medical records to validate the accuracy and integrity of the data.  Ensures all documents are scanned, indexed, and transferred in a timely and efficient manner to ensure the meeting of productivity standards and the quality of work. 

·    Assists in maintaining database containing providers' chart retrieval preferences to support successful and optimal chart retrieval projects.  

·    Orients, trains and assists more junior level staff as needed.

·    Performs other duties as assigned.

Qualifications

Medical Record Retrieval Specialist

Education and Experience:

·   Bachelors' Degree in Business, Healthcare Administration, or Health-related field preferred, but will consider collective experience, training and education.

·   3 years' experience in health care business operations, 1 year of which is in the area of billing and coding, medical records, quality assurance, or utilization review.

Professional Certification(s):

·    Medical Technology or Health Information Technology certification preferred.

Technical Skills and Knowledge:

·    Basic knowledge of Marketplace and Medicare within a managed care insurance industry.

·  Knowledge of Health Insurance Portability & Accountability Act (HIPAA) and Protected Health Information (PHI) regulations.

·    Intermediate proficiency with Electronic Health Records (EHR) and document management systems (e.g. OnBase)

·    Intermediate Microsoft Office (Word, Excel and PowerPoint) skills.

Sr. Medical Record Retrieval Specialist

Education and Experience:

·   Bachelors' Degree in Business, Healthcare Administration, or Health-related field preferred, but will consider collective experience, training and education.

·  5 years' experience in health care business operations in the area of billing and coding, medical records, quality assurance or utilization review, at least 2 years of which is as a Medical Record Retrieval Specialist. 

Professional Certification(s):

·   Certified Professional Coder (CPC) preferred.

Technical Skills and Knowledge:

·   Strong knowledge of Marketplace and Medicare within a managed care insurance industry.

· Knowledge of Health Insurance Portability & Accountability Act (HIPAA) and Protected Health Information (PHI) regulations.

·  Advanced proficiency with Electronic Health Record (EHR) and document management systems (e.g. OnBase).

·  Intermediate Microsoft Office (Word, Excel and PowerPoint) skills.

·  Ability to identify needs, offer solutions, overcome objections, seek closure to issues and provide meaningful feedback to management team, vendors, or providers.

·  Ability to orient, train and assist more junior level staff.

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:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

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.