Retrieval Specialist JHP

Number of Positions In Requisition 4

Job Details

The Retrieval Specialist is a non-clinical, operations-focused role responsible for executing the day-to-day medical record retrieval activities supporting all retrievals for Jefferson Health Plans (e.g., Quality/HEDIS, SIU, Care Management, and Risk Adjustment programs). Working from assignments, the Retrieval Specialist contacts providers using the appropriate retrieval method, follows-up to ensure record receipt, and intakes and stores retrieved records according to JHP's established naming and filing conventions. This role is central to the shared service team's ability to meet program timelines and maintain a complete, well-organized record of retrieval activity. The Specialist maintains accurate work queue information, documents provider outreach and retrieval outcomes, and escalates issues or incomplete records in accordance with established procedures.

Job Description

Summary
The Retrieval Specialist is a non-clinical, operations-focused role responsible for executing the day-to-day medical record retrieval activities supporting all retrievals for Jefferson Health Plans (e.g., Quality/HEDIS, SIU, Care Management, and Risk Adjustment programs). Working from assignments, the Retrieval Specialist contacts providers using the appropriate retrieval method, follows-up to ensure record receipt, and intakes and stores retrieved records according to JHP's established naming and filing conventions. This role is central to the shared service team's ability to meet program timelines and maintain a complete, well-organized record of retrieval activity. The Specialist maintains accurate work queue information, documents provider outreach and retrieval outcomes, and escalates issues or incomplete records in accordance with established procedures.

Job Duties

• Interacts with co-workers, visitors, and other staff in a professional manner consistent with organizational values.
• Receives and reviews assigned work queues from the Manager, assesses provider outreach method and program priority, and organizes workload to meet established retrieval deadlines and productivity targets.
• Maintains an accurate and up-to-date personal work queue in the designated tracking system, including real-time status updates and clear daily and weekly prioritization.
• Conducts provider outreach through assigned retrieval methods, which may include electronic medical record portals, fax, mail, and on-site retrieval as applicable.
• Documents all outreach attempts, follow-ups, provider responses, and retrieval outcomes in the designated tracking system in a timely and consistent manner.
• Reviews received records for completeness and verifies alignment with the original retrieval request prior to storing any documentation.
• Applies established naming conventions, uploads records into the designated document management system, and confirms successful indexing and storage.
• Tracks retrieval status supports cycle-end reconciliation and maintains complete work queue data to support reporting and performance monitoring.
• Follows standard operating procedures and applicable regulatory requirements, including HIPAA, when handling medical records and protected health information.
• Escalates provider issues, incomplete records, system concerns, and other operational barriers promptly to the Team Manager or designated escalation contact (e.g., Provider Relations).
• Supports quality review, training, process improvement initiatives, and other shared team activities as assigned.
• Maintains effective communication with provider offices and internal partners regarding retrieval status and outstanding documentation needs.

Minimum Qualifications

• High School Diploma/GED
• 3 years in medical record retrieval, health information management, medical office operations, or managed care administrative functions.
• Experience working in a high-volume work queue or deadline-driven operations environment.
• Experience supporting Medicare Advantage, Medicaid, or other CMS-regulated health plan programs.
• Strong attention to detail with a consistent commitment to accuracy and quality across all aspects of work.
• Strong customer service skills and professional judgment when engaging with external partners and internal stakeholders.
• Ability to manage a high-volume workload, prioritize tasks effectively, and consistently meet deadlines with minimal supervision.
• Ability to apply established standards, conventions, and procedures consistently and correctly across all aspects of the role.
• Clear written and verbal communication skills, with the ability to interact professionally with both external partners and internal stakeholders.
• Proficiency with Microsoft Office Suite, including Excel, Outlook, and Teams.
• Ability to conduct professional, persistent, and solution-oriented outreach across multiple communication channels.
• Ability to maintain accurate records and ensure tracking systems and documentation are current and up to date in real time.
• Strong organizational, multitasking, problem-solving, and time-management skills.
• Ability to work both independently and collaboratively as part of a team.
• Ability to escalate issues proactively and always maintain work / documentation in audit-ready condition.
• Ability to travel
• DL - Driver's License_PA - State of Pennsylvania or
• DL - Driver's License_NJ - State of New Jersey or
• DL - Driver's License_DE - State of Delaware

Preferred Qualifications

• Associate’s Degree in health information management, Healthcare Administration, or a related field.
• Experience with OnBase or another electronic document management system.
• Experience with any clinical document retrieval tracking tool.
• Experience navigating electronic medical record (EMR) or provider portal systems.
• Ability to learn and work effectively in electronic document management and retrieval tracking platforms.
• CPHIMS - Certified Professional Healthcare Information & Management Systems - Healthcare Information and Management Systems Society or
• CHDA - Certified Health Data Analyst - American Health Information Management Association or
• CCA - Certified Coding Associate - American Health Information Management Association or
• RHIT - Registered Health Information Technician - American Health Information Management Association

Additional Qualifications

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Health Partners Plans, Inc.

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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