JOB SUMMARY 

This job is responsible for requesting and obtaining medical records from healthcare providers to ensure accurate documentation of members’ health conditions and optimize risk adjusted revenue for the organization.  Primary duties include provider outreach, identifying and coordinating the most efficient retrieval methods with provider offices, and ensuring successful receipt of records into secure organizational repositories.  Adheres to all HIPAA regulations and preserves the highest level of security and confidentiality when handling all medical record information. 

ESSENTIAL RESPONSIBILITIES 

• Collect medical records according to tight timeframes and facilitates storage of records in secure organizational repositories.  Tracks and documents activity completely and accurately in all systems in a timely manner.  (70%)
• Contacts provider offices and/or facilities to request copies of medical records, and acts as the point of contact for inquiries regarding medical record requests, while identifying and coordinating the most efficient retrieval methods with providers, such as onsite retrieval, secure electronic access, or secure web upload.  Effectuates what constitutes a complete EMR and process needed to withdraw necessary information to a provider in order to make sure accurate information is being attained. (10%)
• Prepares hard copy medical records for conversion into electronic images. (10%)
• Effectively communicates with team members and external healthcare providers to ensure adherence to strict project deadlines. (5%)
• Travels to provider offices, medical facilities, or Highmark campus to obtain and prepare medical records. (5%)
• Performs other duties as assigned or requested. 

EXPERIENCE 

 
Required 

• 3 years of Prior health care and/or health insurance experience, or related field
• Proficiency in Microsoft Office Tools:  Outlook, Excel, Word, Visio
• Must complete all access requirements and requested forms, which may include, but not limited to, providing personal social security number and/or copy of photo identification, as applicable, in order to retrieve medical records.

Preferred 

• PDF viewer/reader/editor, scanners, flash drives, navigation of document repository, tracking requests, and maintaining issues logs
• Experience and familiarity with medical records, medical terminology, and Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems preferred.
• Proficiency in navigating and retrieving clinical information from EMR/HER systems
• Working knowledge of HIPAA requirements and demonstrated commitment to privacy, security, and confidentiality of protected health information (PHI)

SKILLS 

• Demonstration of company core values of Teamwork, Integrity, Personal Responsibility, Passion, Excellence, and Respect.
• Strong verbal and written communication skills.
• Demonstrate time management skills and ability to manage projects to a successful outcome.
• Well organized, paying close attention to detail.
• Analytical, with an ability to identify and resolve problems.
• Work independently of a direct supervisor while offsite.
• Ability to adapt to change and respond to difficult and challenging situations in a professional manner.
• Ability to work independently or in a team environment. 
• Ability to handle multiple priorities in a timely manner and effectively prioritize tasks. 

EDUCATION 

 
Required 

• High School/GED

Preferred 

Language (Other than English): 

None 

Travel Requirement: 

0% - 25% 

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS 

Position Type 

Office- or Remote-based 

 Office based

Teaches / trains others 

Occasionally 

Travel from the office to various work sites or from site-to-site 

Occasionally

Works primarily out-of-the office selling products/services (sales employees) 

Never 

Physical work site required 

Yes 

Lifting: up to 10 pounds 

Frequently 

Lifting: 10 to 25 pounds 

Occasionally 

Lifting: 25 to 50 pounds 

Rarely 

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. 
 
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. 
 
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.  
 
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.