Medicare-Risk Adjustment Record Retrieval Assoc

What WillBe Your Purpose:

This position serves as the Risk Adjustment Medical Record Retrieval Associate for member and provider chart procurement and audit project activities for the Medicare Advantage population. This position will drive all procurement efforts with providers.

What Will You Be Doing:

  • Uses provider’s external Electronic Medical Records (EMR) system access to perform risk adjustment validation audits and/or blind audits if access granted by physician group.
  • Perform follow-up telephone outreach to provider/provider groups on behalf of Florida Blue and/or contracted vendor chart chases
  • Medical Record Management (splitting PDF charts) and processing EMR Downloads and Secure File Transmission (SFT) Downloads
  • Monitor/manage RPM Outlook Mailbox (charts and provider inquiries coming to this mailbox)
  • Research and resolve non-retrievable chart chase inventory for procurement vendors and Vendor Portal Downloads
  • Preparing UPS Shipping Labels, SME for Special Project Assignments
  • P-Card and Voucher Invoice handling (managed and unmanaged)

WhatYou MustHave:

  • Required Work Experience
    3+ years related work experience. Experience Details:
  • Required Management Experience
    No supervisory/management experience required
  • Required Education
    High school diploma or GED
  • Must possess strong problem solving and decision-making skills
  • Must possess strong verbal and written communication skills Proficient with Microsoft Office, including Word, Excel and PowerPoint
  • Demonstrated success working in an environment that requires attention to details
  • Proven track record of dependability
  • Must be task and goal oriented to meet required deadlines
  • Must be multitask oriented in a fast-paced environment
  • Must be self-motivated to request or take on additional work and not wait for work to be assigned.
  • Must be able to learn quickly and stay on task through completion of assigned duties.
  • Must be presentable in a professional manner and be a team player
  • Must have a valid Florida driver’s license and reliable transportation

What We Prefer:

  • Demonstrated knowledge of Health Plan and HIPPA guidelines
  • Previous experience in the medical record retrieval field
  • Knowledge of medical terminology

General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

What We Offer:
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

  • Medical, dental, vision, life and global travel health insurance;
  • Income protection benefits: life insurance, Short- and long-term disability programs;
  • Leave programs to support personal circumstances;
  • Retirement Savings Plan includes employer contribution and employer match;
  • Paid time off, volunteer time off, and 11 holidays
  • Additional voluntary benefits available; and
  • A comprehensive wellness program
  • Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

    To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

    Hourly Pay Range: $19 – $31

    Typical Hourly Pay Range: $19 – $24

    Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

    We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.

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