Chart Retrieval Analyst I

SummaCare is a regional, provider-owned health plan that values the relationship between its members and their doctors. The Chart Retrieval Analyst I will perform essential functions in Risk Adjustment, including chart retrieval, medical record tracking, and ensuring data quality while providing exceptional client support for a positive customer experience.

Responsibilities

• Perform chart retrieval, medical record tracking, processes invoices / check requests, performs outreach phone calls, ensures data quality oversite while resolving inquiries / issues by utilizing exceptional client support to ensure a positive customer experience
• Assist in the development and management of activities in support of HCC coding while ensuring compliant practices for revenue management and reducing risk
• Support the Risk Adjustment Data Validations (RADV) audits by ensuring all documents are transferred, logged and archived
• Responsible for the delivery of clinical education materials to network providers as well of receiving all necessary medical documentation in support of related risk adjustment activities

Skills

• Associate degree or equivalent combination of education and/or experience
• Ability to travel to and from provider on an as needed basis
• Demonstrate knowledge of Microsoft Office suite
• Organize and manage time to accurately complete tasks within designated periods in fast-paced environment
• Strong professional skills to assist provider and members with inquiries, resolving issues and ensuring a positive customer experience
• Strong communication skills, especially active listening to confirm the client's needs are heard and understood in order to respond in an appropriate manner to ensure successful outcomes
• Strong personal skills to develop long lasting relationships founded on patience, professionalism, and people first attitudes
• Has a working knowledge of medical coding concepts, clinical procedural and diagnostic code sets
• Maintain current knowledge of, comply with regulatory, and company policies and procedures
• Maintain confidentiality of patient and business information
• Demonstrate strong attention to detail and understanding the medical record
• Flexible: ability to adjust work hours to meet business demands
• Sit for prolonged periods
• Bend, stoop, and stretch
• Lift up to 20 pounds
• Manual dexterity to operate computer, phone, and standard office machines
• One (1) years of work experience in an administrative support or customer service role preferred
• Willing to be trained in technical areas such as SQL Server, SSIS and Business Intelligence tools
• Ability to be trained in new functional areas related to risk adjustment such as medical record retrieval, EMR systems and payment forecasting

Benefits

• Medical
• Dental
• Vision
• Life
• Paid time off
• Basic Life and Accidental Death & Dismemberment (AD&D)
• Supplemental Life and AD&D
• Dependent Life Insurance
• Short-Term and Long-Term Disability
• Accident Insurance, Hospital Indemnity, and Critical Illness
• Retirement Savings Plan
• Flexible Spending Accounts – Healthcare and Dependent Care
• Employee Assistance Program (EAP)
• Identity Theft Protection
• Pet Insurance
• Education Assistance
• Daily Pay

Company Overview