SummaCare is a regional, provider-owned health plan that values the relationship between its members and their doctors. The Chart Retrieval Analyst I will perform essential functions in Risk Adjustment, including chart retrieval, medical record tracking, and ensuring data quality while providing exceptional client support for a positive customer experience.
Responsibilities
- Perform chart retrieval, medical record tracking, processes invoices / check requests, performs outreach phone calls, ensures data quality oversite while resolving inquiries / issues by utilizing exceptional client support to ensure a positive customer experience
- Assist in the development and management of activities in support of HCC coding while ensuring compliant practices for revenue management and reducing risk
- Support the Risk Adjustment Data Validations (RADV) audits by ensuring all documents are transferred, logged and archived
- Responsible for the delivery of clinical education materials to network providers as well of receiving all necessary medical documentation in support of related risk adjustment activities
Skills
- Associate degree or equivalent combination of education and/or experience
- Ability to travel to and from provider on an as needed basis
- Demonstrate knowledge of Microsoft Office suite
- Organize and manage time to accurately complete tasks within designated periods in fast-paced environment
- Strong professional skills to assist provider and members with inquiries, resolving issues and ensuring a positive customer experience
- Strong communication skills, especially active listening to confirm the client's needs are heard and understood in order to respond in an appropriate manner to ensure successful outcomes
- Strong personal skills to develop long lasting relationships founded on patience, professionalism, and people first attitudes
- Has a working knowledge of medical coding concepts, clinical procedural and diagnostic code sets
- Maintain current knowledge of, comply with regulatory, and company policies and procedures
- Maintain confidentiality of patient and business information
- Demonstrate strong attention to detail and understanding the medical record
- Flexible: ability to adjust work hours to meet business demands
- Sit for prolonged periods
- Bend, stoop, and stretch
- Lift up to 20 pounds
- Manual dexterity to operate computer, phone, and standard office machines
- One (1) years of work experience in an administrative support or customer service role preferred
- Willing to be trained in technical areas such as SQL Server, SSIS and Business Intelligence tools
- Ability to be trained in new functional areas related to risk adjustment such as medical record retrieval, EMR systems and payment forecasting
Benefits
- Medical
- Dental
- Vision
- Life
- Paid time off
- Basic Life and Accidental Death & Dismemberment (AD&D)
- Supplemental Life and AD&D
- Dependent Life Insurance
- Short-Term and Long-Term Disability
- Accident Insurance, Hospital Indemnity, and Critical Illness
- Retirement Savings Plan
- Flexible Spending Accounts – Healthcare and Dependent Care
- Employee Assistance Program (EAP)
- Identity Theft Protection
- Pet Insurance
- Education Assistance
- Daily Pay
Company Overview
Summa Health is a non-profit medical care that offers orthopedic, weight management, sleep medicine, mental, and digestive health services. It was founded in 1989, and is headquartered in Akron, Ohio, USA, with a workforce of 5001-10000 employees. Its website is http://www.summahealth.org/.
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