Medical Records Retrieval Specialist

Become a part of our caring community. The Medical Records Retrieval Specialist conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. This is a remote role with field-based responsibility, requiring travel to provider offices to retrieve, review, and validate medical records on-site in or around the South Bend, Indiana area.

This position performs moderately complex administrative and operational tasks in a remote and field-based, structured environment, focusing on accuracy, compliance, and efficiency.

Scheduled hours are Monday through Friday from 8:00 AM to 5:00 PM EST, with occasional schedule flexibility to support business needs.

Responsibilities include collecting medical records to ensure accuracy of member information and obtaining provider signatures; uploading verified documents to a centralized repository; complying with state and federal regulations and internal policies when retrieving records; applying departmental procedures accurately; using a laptop, portable scanner, and encrypted flash drive to retrieve and upload medical records; communicating efficiently with physician offices by phone and email; maintaining confidentiality and safeguarding protected health information in compliance with HIPAA; and independently managing workload within defined service level expectations.

Travel requirements include residing within a 50-mile radius of South Bend, Indiana, ability to travel up to 40% during peak season, and having reliable transportation.

Qualifications:

• At least 1 year of customer service experience.
• At least 1 year working with medical records.
• Proficiency with Microsoft Teams and Outlook.
• Ability to manage high task volume across parallel workflows and maintain professional conduct.
• Experience communicating with internal and external stakeholders.
• Knowledge or experience in healthcare environment or managed care (provider office, billing, coding, release of information).
• Valid driver's license and required vehicle insurance.

Preferred qualifications include a bachelor's degree in a related field, knowledge of ICD-9/10 codes, medical terminology, and experience with EMR systems.

Work at home requirements include high-speed DSL or cable modem, dedicated workspace free of interruptions to protect PHI/HIPAA information.

Humana offers competitive benefits including medical, dental, vision, 401(k) plan, paid time off, parental leave, disability, life insurance, and more.

Equal opportunity employer committed to affirmative action and non-discrimination.