**Company :**

Highmark Inc.

**Job Description :**

**JOB SUMMARY**

This job is responsible for requesting and obtaining medical records from healthcare providers to ensure accurate documentation of members' health conditions and optimize risk adjusted revenue for the organization. Primary duties include provider outreach, identifying and coordinating the most efficient retrieval methods with provider offices, and ensuring successful receipt of records into secure organizational repositories. Adheres to all HIPAA regulations and preserves the highest level of security and confidentiality when handling all medical record information.

**ESSENTIAL RESPONSIBILITIES**

Collect medical records according to tight timeframes and facilitates storage of records in secure organizational repositories.Tracks and documents activity completely and accurately in all systems in a timely manner. (35%)

Contacts provider offices and/or facilities to request copies of medical records, and acts as the point of contact for inquiries regarding medical record requests, while identifying and coordinating the most efficient retrieval methods with providers, such as onsite retrieval, secure electronic access, or secure web upload.Effectuates what constitutes a complete EMR and process needed to withdraw necessary information to a provider in order to make sure accurate information is being attained. (25%)

Performs research and investigation to ensure successful retrieval with provider offices, troubleshooting issues as they arise.Requests further information/verification from providers in the event that an incomplete/incorrect EMR is provided. (10%)

Travels to provider offices, medical facilities, or Highmark campus to obtain and prepare medical records. (10%)

Effectively communicates with team members and external healthcare providers to ensure adherence to strict project deadlines. (5%)

Utilizes knowledge of medical records to audit the accuracy, completion and pertinence of EMR. (5%)

Prepares hard copy medical records for conversion into electronic images. (5%)

Identifies and seeks out process improvement opportunities to improve workflow efficiency and contributes to the design of solutions and documentation of standard operating procedures (SOPs). (5%)

Performs other duties as assigned or requested.

**EXPERIENCE**

**Required**

5 years of Prior health care, health insurance experience, or related field

Proficiency in Microsoft Office Tools:Outlook, Excel, Word, Vision

Must complete all access requirements and requested forms, which may include, but not limited to, providing personal social security number and/or copy of photo identification, as applicable, in order to retrieve medical records.

**Preferred**

PDF viewer/reader/editor, scanners, flash drives, navigation of document repository, tracking requests, and maintaining issues logs

Experience and familiarity with medical records, medical terminology, and Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems preferred.

Proficiency in navigating and retrieving clinical information from EMR/EHR systems

Working knowledge of HIPAA requirements and demonstrated commitment to privacy, security, and confidentiality of protected health information (PHI)

**SKILLS**

Demonstration of company core values of Teamwork, Integrity, Personal Responsibility, Passion, Excellence, and Respect.

Strong verbal and written communication skills.

Demonstrate time management skills and ability to manage projects to a successful outcome.

Well organized, paying close attention to detail.

Analytical, with an ability to identify and resolve problems.

Work independently of a direct supervisor while offsite.

Ability to adapt to change and respond to difficult and challenging situations in a professional manner.

Ability to work independently or in a team environment.

Ability to handle multiple priorities in a timely manner and effectively prioritize tasks.

**EDUCATION**

**Required**

Associates in health Information Technology or other health care related field **OR** 3 years of relevant experience in lieu of a degree

**Preferred**

None

**LICENSES or CERTIFICATIONS**

**Required**

None

**Preferred**

Registered Health Information Technician (RHIT)

**Language (Other than English)** **:**

None

**Travel Requirement:**

0% - 25%

**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**

**Position Type**

Office- or Remote-based

Office based

Teaches / trains others

Frequently

Travel from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Frequently

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._

**_Compliance Requirement_** **_:_** _This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_ _._

_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.? In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.?_

_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._

**Pay Range Minimum:**

$17.20

**Pay Range Maximum:**

$27.82

_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( _https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf_ )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J245976