Risk Adjustment Chart Retrieval Specialist

Blue Cross and Blue Shield of Kansas is looking to add to our Risk Adjustment team and has an opportunity for a Risk Adjustment Chart Retrieval Specialist. This position will be responsible for requesting and processing provider medical records for a variety of Risk Adjustment and Quality improvement projects and audits, tracking the progress of outstanding requests, researching, and answering provider questions, and sending records to multiple vendors and auditors. This position will also be responsible for reviewing claims and enrollment information to support risk adjustment data submission processes. This position is in a fast-paced, developing area.

Hybrid Work Eligibility: This position is eligible to work hybrid (9 or more days a month onsite) after six (6) months training in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

Why Join Us?

Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.
Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.
Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
Trust: Work for one of the most trusted companies in Kansas.
Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.

Compensation:

$25.58 - $30.40

Non-exempt Grade 13

Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

What you’ll do:

Request medical records from providers for a variety of Risk Adjustment and Quality improvement projects and audits using an internally developed medical chart tracking application.
Manually generate request letters and supplemental data files for providers that have special medical record request requirements.
Download records from provider Electronic Medical Record systems.
Log incoming medical records via fax, mail, email, or electronic medical record access in the medical chart tracking application.
Develop and maintain knowledge on what is needed in medical records for Risk Adjustment and Quality record requests.
Review medical records for required information and discard any unnecessary information.
Contact provider offices with a high degree of professionalism and confidence to communicate expectations of charts required, attestations, etc.
Research provider submitted claims through Imaging resources to provide additional information on medical record requests when needed.
Package and send medical records to internal coding team, vendors, and auditors.
Assist with risk adjustment data submissions by reviewing and editing enrollment and claims records pended for manual review.

What you need:

High school degree or equivalent is required.
Strong computer skills in data entry, Microsoft Office products, and Adobe Pro.
Must safeguard protected health information as required by HIPAA Privacy regulations.
Must be able to maintain confidentiality.
Regular and predictable attendance is an essential job function as defined by policy.
Must comply and implement corporate information security policies, standards, and guidelines relative to access control.
Requires close attention to detail, strong grammar and reading comprehension skills, along with strong critical thinking and problem-solving skills.
Ability to work independently with minimum supervision, excellent reliability, and demonstrated ability to work timely and effectively under strict deadlines.
Ability to develop positive relationships with internal and external customers as well as co-workers.
Ability to multitask, prioritize and manage time efficiently.
Excellent verbal and written communication skills.
Ability to accept ownership of job responsibilities in a self-directed team environment.
More than 90% of the workday is at a PC.
Lifting boxes of medical records of up to 20 lbs.
May require non-standard working hours such as but not limited to weekends.

Bonus if you have:

Medical office experience preferred.

Benefits & Perks:

Base pay is only one component of your competitive Total Rewards package:
- Incentive pay program (EPIP).
- Health/Vision/Dental insurance.
- 6 weeks paid parental leave for new mothers and fathers.
- Fertility/Adoption assistance.
- 2 weeks paid caregiver leave.
- 5% 401(k) plan matching.
- Tuition reimbursement.
- Health & fitness benefits, discounts, and resources.

Posting Close Date:

Pay Rate Type: Hourly

About Us

For more than 70 years, Blue Cross and Blue Shield of Kansas has built a reputation of trust. As we move forward in this new era of health care we want to continue that tradition. Whether a member needs Blue Cross to cover an annual check-up or give them peace of mind during a major medical crisis, we want our members to know they can trust BCBSKS to meet their needs. Our mission: Being the insurer Kansans trust with their health.

***Equal Opportunity Employer/Veterans/Disabled***

***Blue Cross Blue Shield of Kansas invites any applicant and/or employee to review the Company’s written Affirmative Action Plan. This plan is available for inspection upon request by contacting the EEO Office at (785)291-8639.***

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Blue Cross & Blue Shield of Kansas, Inc. jobs

Risk Adjustment Chart Retrieval Specialist