Job Description

Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

Internal use only-grade 12-13

The Record Retrieval Coordinator supports the organization's need to obtain and audit medical records and similar documents to meet BCBS Association medical record retrieval targets for risk adjustment, HEDIS, and performance measure calculation for the Medicare Advantage Coordination of Care (PEX) Program.

REQUIRED QUALIFICATIONS

Required Work Experience

  • 1 year in any of the following: physician office support staff, HIM department, electronic medical records, Release of Information or documented experience with computer software and hardware

Required Education

  • High-School Diploma or GED in field of study

Required Licenses

  • Valid Arizona Driver License, with an acceptable driving record

Required Certifications

  • N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

  • HEDIS medical record retrieval

Preferred Education

  • N/A

Preferred Licenses

  • N/A

Preferred Certifications

  • CCA or CPC coding certification

ESSENTIAL job functions AND RESPONSIBILITIES

  • Request medical records from physician offices/hospitals by fax or mail
  • Successful processing of faxed or mailed medical records and follow up with physician offices regarding records not received on time
  • Review all records retrieved to be sure they are for the correct member, Provider Engagement Request ID, provider, and date range included on the request.
  • Report daily productivity and retrieval numbers to supervisor. Identify reasons records were not retrieved
  • Meet a goal of retrieving 95% of records per project with 95% accuracy (includes retrieving claims screen shots from claims system, medical records from electronic medical records systems, faxes, and mail)
  • Track, trend, and escalate barriers to supervisor
  • Establish positive and professional relationships with care provider offices, clinics, hospitals, other clinical facilities and Medicaid Business Segment staff
  • Abide by all HIPAA and associated patient confidentiality requirements. Prevent all data breaches.
  • Attend all MA Coordination of Care (PEX) meetings with other blue plans, our vendor Ellkay, and Association enhancement testing calls
  • Complete Ellkay PEX UI training with medical records lead
  • Work in collaboration with the MA Coordination of Care medical record lead to learn the business requirements and workflow processes of the program needed to meet all requirements
  • Perform all other duties as assigned
  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements

competencies

REQUIRED COMPETENCIES

Required Job Skills

  • The role requires organization and delivery of medical records per department system (i.e. using correct shared folders, correct naming conventions) in an accurate, well-organized and timely manner to allow timely processing of medical records to PEX to meet the Association Key Performance Indicator targets.
  • Strong knowledge of HIPAA rules and regulations
  • Comprehensive knowledge of computers and software such as Microsoft Windows, Excel, Word, PDF file creation and conversion, portable scanners
  • Ability to learn basic working skills with new software in short timeframes
  • Basic understanding of the contents of a medical chart/electronic medical record programs

Required Professional Competencies

  • Ability to problem solve to complete an objective
  • Strong customer service skills and techniques
  • Strong oral, phone and written communication skills
  • Ability to adapt to new surroundings and changing office environments

Required Leadership Experience and Competencies

  • N/A

PREFERRED COMPETENCIES

Preferred Job Skills

  • Bilingual in English/Spanish

Preferred Professional Competencies

  • N/A

Preferred Leadership Experience and Competencies

  • N/A

Our Commitment

BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see azblue.com.  If interested in this position, please apply.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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