Medical Records Retrieval Specialist - North Carolina

📋 Description

• • The Medical Records Retrieval Specialist conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to CMS and other government agencies, ensuring accuracy and compliance in a remote, field-based role requiring travel to provider offices in the Wilmington, NC area.
• • Day-to-day responsibilities include collecting medical records, verifying member information, obtaining provider signatures, uploading documents to Cotiviti’s centralized repository, interpreting departmental procedures, using laptops, portable scanners, and encrypted flash drives, conducting high-volume calls and emails to physician offices, maintaining HIPAA-compliant confidentiality of PHI, and independently managing workload to meet service level expectations.
• • Humana Inc. is a leading U.S. healthcare company dedicated to improving health outcomes for millions through its insurance and CenterWell services, emphasizing quality, compliance, and whole-person well-being in a mission-driven, equal-opportunity workplace.
• • In this role, you will develop expertise in medical record retrieval, healthcare compliance, HIPAA standards, ICD-9/10 coding, and healthcare operations while gaining experience in field-based audits, cross-functional communication, and independent workload management within a structured, mission-critical healthcare support function.