Risk Adjustment Chart Retrieval Specialist
Blue Cross and Blue Shield of Kansas is looking to add to our Risk Adjustment team and has an opportunity for a Risk Adjustment Chart Retrieval Specialist. This position will be responsible for requesting and processing provider medical records for a variety of Risk Adjustment and Quality improvement projects and audits. This position will be responsible for tracking the progress of outstanding requests, researching, and answering provider questions, and sending records to multiple vendors and auditors. This position will also be responsible for reviewing claims and enrollment information to support risk adjustment data submission processes. This position is in a fast-paced, developing area.
"This position is eligible to work hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy, after training is complete. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment."
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Why Join Us?
- Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.
- Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.
- Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
- Trust: Work for one of the most trusted companies in Kansas.
- Stability: 80 years of commitment, compassion, and community
- Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.
- 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
- High school degree or equivalent is required.
- Strong computer skills in data entry, Microsoft Offices products and Adobe Pro.
- More than 90% of the workday is at a PC.
- Lifting boxes of medical records of up to 20 lbs.
- May require non-standard working hours such as but not limited to weekends
- 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.
- Medical office experience preferred.
- Base pay is only one component of your competitive Total Rewards package:
- Incentive pay program (EPIP)
- Health/Vision/Dental insurance
- 6 weeks paid parental leave for new mothers and fathers
- Fertility/Adoption assistance
- 2 weeks paid caregiver leave
- 5% 401(k) plan matching
- Tuition reimbursement
- Health & fitness benefits, discounts and resources