The Medical Records Retrieval Specialist/ Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments.

Additional Information – How we Value You
Benefits starting day 1 of employment
Competitive 401k match
Generous Paid Time Off accrual
Tuition Reimbursement
Parent Leave
Go365 perks for well-being

Responsibilities

This position requires 60-80% travel to provider offices in and around San Bernardino County.

The Medical Records Retrieval Specialist/ Risk Adjustment Representative 2 ensures accurate and properly supported clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines while analyzing medical records. Decisions typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

• Travel up to 60-80% of the time and will consist of driving to locations close to your home, as well as driving to locations that may require overnight travel for up to a week at a time.
• Use a laptop computer and a portable scanner to retrieve medical records which will be uploaded into a database.
• Schedule appointments and visits to physician offices in a timely, efficient manner to meet all deadlines.

Required Qualifications

• Must Live in San Bernardino County.
• Knowledge of health care environment/managed care (provider office, billing, coding, medical records, etc.)
• Strong written and verbal communication skills; strong analytical, organizational and time management skills
• Proficiency in Microsoft Office applications: Word and Excel
• Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills including ability to learn new computer programs
• This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits
• Ability to provide a designated workspace; free from distractions with the ability to secure any protected information.
• Our company requires vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Preferred Qualifications

• Experience in EMR (Electronic Medical Records) system

Additional Information

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time.

These requirements include:

Access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m
Dedicated secure home workspace for interview or work purposes.
Humana continues to monitor the situation, and will adjust service levels as the corona virus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and well-being during the hiring process.

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Scheduled Weekly Hours

40