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Blue Cross and Blue Shield of Kansas · 1 day ago

Risk Adjustment Chart Retrieval Specialist

Topeka

Full-time

Hybrid

New Grad, Entry Level

$27.08/hr - $33.80/hr

Blue Cross and Blue Shield of Kansas is looking to add to their Risk Adjustment team with an opportunity for a Risk Adjustment Chart Retrieval Specialist. This role is responsible for requesting and processing provider medical records for various Risk Adjustment and Quality improvement projects and audits, while also tracking progress and supporting data submission processes.

Financial ServicesHealth Care

Growth Opportunities

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

Qualification

Data entryMicrosoft OfficeHIPAA complianceAdobe ProMedical office experienceAttention to detailCommunication skillsProblem-solvingTime management

Required

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