Join Humana as a Medical Records Retrieval Specialist where you will conduct quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to CMS and other government agencies. This role is remote with field-based responsibilities requiring travel to provider offices around Nashville to retrieve, review, and validate medical records on-site.
You will perform moderately complex administrative and operational tasks remotely and on-site, focusing on accuracy, compliance, and efficiency.
Key responsibilities include collecting medical records to verify member information, uploading verified documents to a centralized repository, ensuring compliance with state and federal regulations and internal policies, communicating with physician offices, safeguarding PHI in compliance with HIPAA, and managing workload independently within service-level expectations.
Scheduled hours are Monday to Friday, 8:00 am - 5:00 pm CST with occasional schedule flexibility. This role requires travel up to 50% of the time in peak seasons within the Nashville Metropolitan area and reliable personal transportation.
Qualifications:
- Minimum 1 year customer service experience
- Minimum 1 year experience with medical records
- Daily use of Microsoft Teams and Outlook
- Experience managing high task volumes and professional conduct
- Knowledge or experience in healthcare/managed care environments
- Valid driver's license and vehicle insurance consistent with state requirements
Preferred qualifications include a Bachelor's degree related to the field, knowledge of ICD-9/10 codes, medical terminology, and experience with EMR systems.
Humana offers competitive benefits, including medical, dental, vision, 401(k), paid time off, parental leave, disability, life insurance, and more.
- Minimum 1+ years customer service experience
- Minimum 1+ years with medical records
- Proficient with Microsoft Teams and Outlook
- Experience managing multiple workflows with high professional standards
- Knowledge or experience in healthcare or managed care (provider office, billing, coding, release of information)
- Valid driver's license and vehicle insurance to state requirements
Preferred:
- Bachelor's degree in related field
- Knowledge of ICD-9/10 codes
- Knowledge of medical terminology
- Experience with EMR systems
Humana provides competitive benefits supporting whole-person well-being including medical, dental, vision insurance, 401(k) retirement plan, paid time off (including holidays, parental and caregiver leave), short-term and long-term disability, life insurance, and other wellness programs.
Location
Nashville, Tennessee, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$40,000 - $52,300
Remote work allowed
Yes
Posted
1 month ago