Medical Record Retrieval Specialist

reputed company is a nonprofit health plan with more than a reputed company members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and reputed company. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven reputed company, embraces reputed company learning, and celebrates collaboration — because reputed company is a team 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 connected care, where coordinated, quality 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, quality programs, and regulatory audits. This role ensures records are obtained accurately, on time, and in compliance with audit and privacy requirements. The specialist works closely with internal clinical and audit teams and external provider offices to resolve documentation gaps, track 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., Epic, 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, index, and organize records in designated systems (e.g., SharePoint, internal audit tools)
• Ensure accurate file naming, version control, and proper record association
• Track retrieval status, provider responses, and outstanding requests
• reputed company quality 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 methods for record transmission 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., Epic, Cerner) and secure document exchange platforms
• Experience working with provider offices or HIM departments
• Knowledge of reputed company quality 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 variety 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 addition to compensation, reputed company offers a generous total rewards package that includes competitive medical, dental, reputed company, PTO, Holidays, paid 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 United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. 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

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