Become a part of our caring community The Medical Records Retrieval Specialist conducts quality assurance audits of medical records and ICD‑9/10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies.
This is a remote role with field‑based responsibility, requiring travel to provider offices to retrieve, review, and validate medical records on‑site in or around the Sumter, SC area and surrounding counties, reporting directly to the Risk Adjustment Supervisor.
The Medical Records Retrieval Specialist performs moderately complex administrative and operational tasks in a remote and field‑based, structured environment, with a focus on accuracy, compliance, and efficiency.
Occasional schedule flexibility may be required to support business needs.
What You'll Do: Collect medical records and conduct research to ensure accuracy of member information and obtain provider signatures.
Upload verified documents to Cotiviti centralized repository within 24-hour time frame.
Interpret and apply departmental procedures to complete assignments with accuracy and efficiency.
Use a laptop computer and a portable scanner and encrypted flash drive to retrieve medical records which will be uploaded into a database.
Conduct a high volume of calls to physician offices by phone and email to efficiently meet all deadlines.
Independently manage workload within defined service level expectations.
MUST be able to.