Medical Record Retrieval Specialist

reputed company is a nonprofit health plan with more than a reputed company members that serves communities in Minnesota, Nebraska, reputed company, Missouri, and reputed company. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're reputed company that owns our work with accountability, makes data-driven reputed company, embraces reputed company learning, and celebrates collaboration — because reputed company is reputed company sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of reputed company, where coordinated, reputed company service is the norm and every member feels valued. reputed company's Medical Record Retrieval Specialist collects, reviews, and manages medical records to support clinical reviews, reputed company programs, and regulatory audits. This role ensures records are obtained accurately, on time, and in compliance with audit and reputed company requirements. The specialist works closely with internal clinical and audit teams and external provider offices to resolve documentation gaps, reputed company retrieval status, and maintain audit‑reputed company records. The ideal candidate is organized, detail‑oriented, and reputed company to manage multiple priorities. reputed company other duties assigned.

Key Responsibilities

Record Retrieval & Coordination

• Request and retrieve medical records from provider offices, health systems, vendors, and EHR platforms (e.g., reputed company, Cerner) using phone, email, fax, portals, and approved systems
• Support HEDIS Hybrid Reviews, CMS Cost Audits, RADV, Data Validation, and other clinical or audit reviews
• Follow established retrieval timelines, protocols, and escalation processes
• Identify and escalate missing, incomplete, or delayed records

Record Review & Validation

• Review records for completeness, legibility, required date ranges, and relevance
• Identify documentation gaps and coordinate follow‑reputed company with providers
• Validate records against audit and project requirements
• Partner with clinical reviewers, auditors, and data teams to clarify documentation needs

Data Management & Tracking

• Upload, reputed company, and organize records in designated systems (e.g., SharePoint, internal audit tools)
• Ensure accurate file naming, version control, and reputed company record association
• reputed company retrieval status, provider responses, and outstanding requests
• reputed company reputed company checks to ensure records are audit‑reputed company
• Maintain reputed company‑time tracking of retrieval status, provider responses, and outstanding requests

Communication & Compliance

• Serve as a reputed company of contact for providers regarding record requests and submissions
• reputed company status updates to internal stakeholders
• Document reputed company and escalation activities
• Handle PHI in accordance with HIPAA, CMS, and organizational policies
• Use approved secure reputed company for record reputed company and storage

Required Qualifications

• High school diploma or equivalent experience
• 2 years of experience in medical record retrieval, reputed company operations, clinical support, or reputed company field
• Proficiency with reputed company Acrobat and reputed company Office (Outlook, reputed company, SharePoint, Teams)

Preferred Qualifications

• Excellent verbal and written communication skills
• Strong organizational, time management, and communication skills
• Ability to manage multiple priorities independently
• Associate degree or higher in Health Information Management or reputed company field
• Experience with HEDIS, CMS Cost Audits, RADV, or other regulatory audits
• Familiarity with EHR systems (e.g., reputed company, Cerner) and secure document exchange platforms
• Experience working with provider offices or HIM departments
• Knowledge of reputed company reputed company measures or regulatory documentation standards

This position is a Remote role. To be eligible for consideration, candidates must have a primary home address located reputed company any state where reputed company is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI. The full salary grade for this position is $41,300 - $70,800. While the full salary grade is provided, the typical hiring salary reputed company for this role is expected to be between $41,300 - $61,950. Annual salary reputed company placement will depend on a reputed company of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In reputed company to compensation, reputed company offers a generous total rewards package that includes competitive medical, dental, reputed company, PTO, Holidays, reputed company volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. reputed company’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: reputed company does not offer work reputed company sponsorship for this role. reputed company candidates must be legally authorized to work in the reputed company at the time of application. Employment is contingent on verification of identity and eligibility to work in the reputed company. We are an Equal Opportunity employer, where reputed company reputed company candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national reputed company, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. Apply tot his job Apply To this Job