Risk Adjustment Medical Record Retrieval Specialist

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to improve the retrieval of medical records for our risk adjustment program. You will establish and maintain contact with medical facilities and retrieval vendors to achieve success and accuracy in the retrieval or targeted medical records. You must have strong attention to detail and a knack for creating systems to store and organize records digitally. You will need to obtain access and retrieve records from a variety of digital platforms, including EHR systems and remote drop-boxes, as well as digital fax and e-mail. Strong communication skills are a must in order to maintain collaborative relationships with medical facilities and our retrieval vendors.

• Establish and maintain ongoing contact with medical facilities. Triage issues at each facility in order to facilitate the retrieval of records.
• Create systems or categorizing and organizing medical records for long-term digital storage.
• Create and execute plans for specific retrieval projects, including identifying high-volume sites, setting retrieval goals and working with internal staff and external vendors to achieve retrieval goals.
• Access various retrieval systems, including remote EHR systems, electronic drop-box and eFAX systems to retrieve and save medical records.
• Use Health Information Technology (HIT) standards to identify proper chart types and valid encounters.
• Use various data elements (incl. date of service, provider type, demographic information, etc) to validate provider visits. Work with facilities to request corrected medical records when necessary.
• Work to transmit medical records between various partners.

• Bachelor's degree required, preferably in health information administration (HIA) or health information technology (HIT); and three (3) years of experience working at a health plan or medical provider/facility.
• Medical record technology or health information technology (HIT) program approved by a nationally accredited agency (e.g., AHIMA or CAHIIM) preferred.

Professional Competencies

• Integrity and trust
• Customer Focus
• Functional/Technical Skills
• Writtan/Oral Communication

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