Job Description
SummaCare is a regional, provider-owned health plan that values the relationship between its members and their doctors. The Chart Retrieval Analyst I will perform essential functions in Risk Adjustment, including chart retrieval, medical record tracking, and ensuring data quality while providing exceptional client support for a positive customer experience. Responsibilities Perform chart retrieval, medical record tracking, processes invoices / check requests, performs outreach phone calls, ensures data quality oversite while resolving inquiries / issues by utilizing exceptional client support to ensure a positive customer experience Assist in the development and management of activities in support of HCC coding while ensuring compliant practices for revenue management and reducing risk Support the Risk Adjustment Data Validations (RADV) audits by ensuring all documents are transferred, logged and archived Responsible for the delivery of clinical education materials to network providers as well of receiving all necessary medical documentation in support of related risk adjustment activities Skills Associate degree or equivalent combination of education and/or experience Ability to travel to and from provider on an as needed basis Demonstrate knowledge of bolthires Office suite Organize and manage time to accurately complete tasks within designated periods in fast-paced environment Strong professional skills to assist provider and members with inquiries, resolving issues and ensuring a positive customer experience Strong communication skills, especially active listening to confirm the client's needs are heard and understood in order to respond in an appropriate manner to ensure successful outcomes Strong personal skills to develop long lasting relationships founded on patience, professionalism, and people first attitudes Has a working knowledge of medical coding concepts, clinical procedural and diagnostic code sets Maintain current knowledge of, comply with regulatory, and company policies and procedures Maintain confidentiality of patient and business information Demonstrate strong attention to detail and understanding the medical record Flexible: ability to adjust work hours to meet business demands Sit for prolonged periods Bend, stoop, and stretch Lift up to 20 pounds Manual dexterity to operate computer, phone, and standard office machines One (1) years of work experience in an administrative support or customer service role preferred Willing to be trained in technical areas such as SQL Server, SSIS and Business Intelligence tools Ability to be trained in new functional areas related to risk adjustment such as medical record retrieval, EMR systems and payment forecasting Benefits Medical Dental Vision Life Paid time off Basic Life and Accidental Death & Dismemberment (AD&D) Supplemental Life and AD&D Dependent Life Insurance Short-Term and Long-Term Disability Accident Insurance, Hospital Indemnity, and Critical Illness Retirement Savings Plan Flexible Spending Accounts – Healthcare and Dependent Care Employee Assistance Program (EAP) Identity Theft Protection Pet Insurance Education Assistance Daily Pay Company Overview Summa Health is a non-profit medical care that offers orthopedic, weight management, sleep medicine, mental, and digestive health services.
It was founded in 1989, and is headquartered in Akron, Ohio, USA, with a workforce of 5001-10000 employees. Its website is