Records Retrieval Specialist

Become a part of our caring community The Medical Records Retrieval Specialist conducts quality assurance audits of medical records and ICD‑9/10 diagnosis codes submitted to CMS and other government agencies. This is a remote role with field‑based responsibility, requiring travel to provider offices to retrieve, review, and validate medical records on‑site in or around the Charlotte Metro area, reporting directly to the Risk Adjustment Supervisor. The Medical Records Retrieval Specialist performs moderately complex administrative and operational tasks in a remote and field‑based structured environment, focusing on accuracy, compliance, and efficiency to support positive member and provider outcomes. Use your skills to make an impact Scheduled Hours The normal business hours for this position are Monday – Friday from 8:00 am – 5:00 pm EST. Occasional schedule flexibility may be required to support business needs. What You’ll Do Collect medical records and conduct research to ensure accuracy of member information and obtain provider signatures. Upload verified documents to Cotiviti centralized repository. Follow state and federal regulations as well as internal policies and guidelines while retrieving medical records. Interpret and apply departmental procedures to complete assignments with accuracy and efficiency. Use a laptop computer and a portable scanner and encrypted flash drive to retrieve medical records which will be uploaded into a database. Conduct a high volume of calls to physician offices by phone and email to efficiently meet all deadlines. Maintain strict confidentiality and safeguard protected health information (PHI) in compliance with HIPAA guidelines. Independently manage workload within defined service level expectations. Travel Requirements Reside within Charlotte, NC or surrounding areas; specifically, Anson, Richmond, Cabarrus, Stanly, Montgomery, and Scotland. Ability to travel and occasionally stay overnight up to 75% of the time at peak season, as needed. Must have reliable transportation. Required Qualifications 1 or more years of experience in customer service. 1 or more years of experience with medical records. 1 or more years of experience using Microsoft 365 and associated applications, such as Teams and Outlook daily to coordinate meetings, manage calendars, and support internal communication. Experience managing high‑volume workloads while ensuring prompt follow‑up and adherence to professional standards. Experience articulating information to internal peers and external partners. Experience in health care environment/managed care (provider office, billing, coding, release of information, etc.) This role is part of Humana’s driver safety program and therefore requires an individual to have a valid state driver’s license and are expected to maintain personal vehicle liability insurance. Individuals must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. Preferred Qualifications Knowledge or experience in health care environment/managed care. Knowledge of ICD‑9/10 codes. Knowledge of medical terminology. Experience and comfort with EMR systems. Work at Home Guidance At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi‑weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range $40,000 - $52,300 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our #J-18808-Ljbffr Humana Inc