Medical Mutual of Ohio Medical Record Retrieval Spec in Cleveland, Ohio

Supports provider education and outreach activities to identify and close coding and care gaps Collaborates with vendors and directly with provider offices/facilities to retrieve medical records. Supports other initiatives related to Risk Adjustment Programs (RAPS) and Healthcare Effectiveness Data and Information Set (HEDIS) while adhering to HIPAA guidelines . Responsibilities · Supports chart retrieval activities for projects related to RAPS and HEDIS efforts. Works closely with providers and other quality team members, Health Informatics, IT and vendor partners. Researches and identifies issues/barriers in effort to maximize successful chart retrieval projects. . Retrieves medical records from a variety of systems including, but not limited to, provider Electronic Medical Record (EMR) systems (i.e. EPIC). Maintains professional relationships with providers to ensure successful and timely chart retrieval. · Reviews incoming medical records to validate the accuracy and integrity of the data. Ensures all documents are scanned and indexed in a timely and efficient manner. · Participates on cross functional teams that develop education and incentive programs for providers related to RAPS, STARS and HEDIS. Collaborates closely with Provider Engagement, Provider Network Performance, and Health Informatics in planning and delivery of reports to close coding and care gaps, and improve member outcomes. · Assists in maintaining database containing provders’ chart retrieval preferences to support successful and optimal chart retrieval projects. · Partners with internal departments on ad hoc initiatives and projects, and performs other duties as assigned

Bachelors’ Degree in Business, Healthcare Administration, or Health-related field preferred, but will consider collective experience, training and education. • 5 years’ experience in health insurance operations, preferably within the provider or facility environment • Experience in the area of medical records, quality assurance or utilization review • Medical Technology or Health Information Technology certification preferred • Certified Professional Coder (CPC) preferred • Microsoft Office (Word, Excel and PowerPoint) skills

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

  • Top Workplace in Northeast Ohio. Seven years in a row we've received this recognition!

  • On-site wellness center at most locations. Enjoy personal trainers, towel service, locker room, weight room, elliptical machines, and a variety of classes!

  • On-site cafeteria serving hot breakfast and lunch, at most locations. Choices ranging from salad bar, made to order, hot and cold sandwiches, or a variety of entrees cooked fresh daily. Convenience store at most locations

  • Employee discount program. Discounts at many places in and around town, just for being a Medical Mutual team member

  • Business casual attire

Excellent Benefits and Compensation:

  • Competitive compensation plans

  • Employee bonus program

  • 401(k) with company match and an additional company contribution

  • Excellent medical, dental, vision, and disability insurance

An Investment in You:

  • Career development programs and classes

  • Mentoring and coaching to help you advance

  • Education reimbursement up to $5K per year

About Medical Mutual:

We strive to create peace of mind. Our customers can trust us to do things right and to help them get value from their health plan. We're the largest health insurer in Ohio and for 80 years, we've been serving our members and the Ohio communities where they live and work. Medical Mutual is a Top Place to Work in Northeast Ohio with exceptional career opportunities that offer challenge, growth and a great work/life balance. We want talented, innovative, and driven people to help us continue to be the best health insurance choice of Ohioans and help make Ohio the best it can be! Our headquarter building is located in the heart of downtown Cleveland and we have multiple offices throughout the state. Join us at one near you!


At Medical Mutual we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing./

Job: *7 - General Staff

Organization: *Medical Performance & Management

Title: Medical Record Retrieval Spec

Location: OH-Cleveland

Requisition ID: 1700386