Risk Adjustment Chart Retrieval Specialist
Blue Cross and Blue Shield of Kansas is looking to add to their Risk Adjustment team with the hiring of a Risk Adjustment Chart Retrieval Specialist. This role involves requesting and processing provider medical records for various projects and audits, tracking requests, and reviewing claims and enrollment information to support risk adjustment data submissions.
Responsibilities
- Request medical records from providers for a variety of Risk Adjustment and Quality improvement projects and audits using an internally developed medical chart tracking application
- Manually generate request letters and supplemental data files for providers that have special medical record request requirements
- Download records from provider Electronic Medical Record systems
- Log incoming medical records via fax, mail, email, or electronic medical record access in the medical chart tracking application
- Develop and maintain knowledge on what is needed in medical records for Risk Adjustment and Quality record requests
- Review medical records for required information and discard any unnecessary information
- Contact provider offices with a high degree of professionalism and confidence to communicate expectations of charts required, attestations, etc
- Research provider submitted claims though Imaging resources to provide additional information on medical record requests when needed
- Package and send medical records to internal coding team, vendors, and auditors
- Assist with risk adjustment data submissions by reviewing and editing enrollment and claims records pended for manual review
Skills
- High school degree or equivalent is required
- Strong computer skills in data entry, Microsoft Offices products and Adobe Pro
- Must safeguard protected health information as required by HIPAA Privacy regulations
- Must be able to maintain confidentiality
- Regular and predictable attendance is an essential job function as defined by policy
- Must comply and implement corporate information security policies, standards, and guidelines relative to access control
- Requires close attention to detail, strong grammar and reading comprehension skills, along with strong critical thinking and problem-solving skills
- Ability to work independently with minimum supervision, excellent reliability, and demonstrated ability to work timely and effectively under strict deadlines
- Ability to develop positive relationships with internal and external customers as well as co-workers
- Ability to multitask, prioritize and manage time efficiently
- Excellent verbal and written communication skills
- Ability to accept ownership of job responsibilities in a self-directed team environment
- Medical office experience preferred
Benefits
- Incentive pay program (EPIP)
- Health/Vision/Dental insurance
- 6 weeks paid parental leave for new mothers and fathers
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