This is a temporary non-benefited assignment with a duration of approximately 4-5 months.
Under direction, the Risk Adjustment Medical Record Analyst's primary responsibilities will be to retrieve, abstract, or over read medical records in order to capture pertinent, required, data elements for Risk Adjustment reporting. The core responsibilities of this role may include but are not limited to:
Collecting member medical records from various electronic medical record (EMR/EHR) systems, performing reviews of electronic medical records to determine if required documentation is present, downloading medical record images to one of our corporate drives, and logging receipt of medical record documentation in appropriate software. Retrieval efforts may also include pursuit via phone call, fax, mail, or direct onsite pickup.
Abstract and/or over read all pertinent medical record data and enter it into a specified Risk Adjustment data base to support Risk Adjustment reporting and Quality Improvement. Abstraction efforts may also include over reading of medical records that have been abstracted by other Risk Adjustment Medical Record Analysts.
Collects assigned medical records from EMR/EHR systems and prepares them for medical record abstraction
Documents retrieval progress/findings for each EMR accessed.
Communicates effectively and professionally with provider offices.
Reviews assigned medical records in order to abstract specified, clinical data elements for Risk Adjustment reporting (e.g. date of service of breast cancer screening, date of service and results of laboratory tests related to chronic conditions)
Documents abstraction findings on appropriate paper and/or electronic tools as directed by the Risk Adjustment MR Team.
Communicates additional pursuit strategies, if needed, to other members of the team as defined in the department's policies and procedures. (e.g. requests a call back to provider office to ask for additional clarifying information.)
Competencies and Knowledge:
Excellent interpersonal skills and ability to work effectively in team environment.
Demonstrated command of medical terminology, navigating EMR/EHR systems, medical record documentation, and clinical processes.
Demonstrated problem solving ability.
Knowledge of Microsoft office products desirable.
Understanding of HIPAA.
Knowledge of ICD-9 and 10-CM, CPT, HCPCS and DRG coding conventions a plus.
Knowledge of FACETS a plus
Experience with quality oversight and teaching desired.
Prior experience in Risk Adjustment and medical record retrieval and/or abstraction for quality or research projects
Normally to be proficient in the competencies listed above:
Risk Adjustment Medical Record Analyst's would have an Associate degree in Nursing or related field and 3 years of experience in a clinical setting, working with medical records, and/or experience with EMR/EHR systems or equivalent combination of education and experience.
Required Licenses, Certifications, Registration, Etc.
One of the following is preferred:
Valid Registered Nursing (RN/LVN/LPN)
CPC - Certified Professional Coder
CCS - Certified Coding Specialist
This is a temporary, non-benefited assignment with an expected duration of approximately 4-5 months. The hourly rate range for this role is $35.00 - 45.00 per hour.
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.