Audit Retrieval Specialist - Remote

Job Description:

Sharecare is a digital healthcare company that delivers software and tech-enabled services to stakeholders across the healthcare ecosystem to help improve care quality, drive better outcomes, and lower costs. Through its data-driven AI insights, evidence-based resources, and comprehensive platform – including benefits navigation, care management, home care resources, health information management, and more – Sharecare helps people easily and efficiently manage their healthcare and improve their well-being. Across its three business channels, Sharecare enables health plan sponsors, health systems and physician practices, and leading pharmaceutical brands to drive personalized and value-based care at scale. To learn more, visit www.sharecare.com.

Job Summary:

The mission of the Audit Fulfillment Program is to track, retrieve, & deliver timely, accurate medical record sets, for all valid use cases, to high-volume institutional requestors.  This position is responsible for processing all release of information requests in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. Associate must always safeguard and protect the patient’s right to privacy by ensuring that only authorized individuals have access to the patient’s medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations.

Essential Job Functions:

• Completes release of information requests including retrieving patient’s medical chart and returning chart, scanning medical record accurately and correctly and transmitting daily, according to requests, established procedures, and established standards of quality and productivity.
• Specifically focused on retrieval projects for health plan and CMS campaigns, including but not limited to: HEDIS, DRG, Risk Adjustment, Payment Integrity, RAC, CMS Audits
• Receive and review audit requests from external entities, ensuring understanding of requirements and deadlines. 
• Identifies audit use case, validates requests and authorizations for release of medical information according to established procedures.
• Maintains up-to-date client account logins/credentials for all assigned locations, including tracking expiration dates and renewal requirements.
• Performs quality checks on all work to assure completeness, accuracy, and compliance with audit criteria and requirements.
• Maintain equipment in excellent operating condition (inside and out).
• Provides excellent customer service by being attentive and respectful; ensures understanding of customer request and follows-through as promised; and being proactive in identifying client concerns, or problems.
• Maintains a neat, clean, and professional personal appearance and observes the dress code established.
• Maintains a clean and orderly work area, ensures that records and files are properly stored before leaving area.
• Maintains working knowledge of the existing state laws and fee structure
• Works within scope of position and direction; willingly accepts assignments and is available to take on additional facilities or help out during backlogs
• Carries out responsibilities in accordance with client/site policies and procedures, including HIPAA, state/federal regulations related to operations, and labor regulations.
• Maintains confidentiality, security and standards of ethics with all information.
• Work with privileged information in a conscientious manner while releasing medical records in an efficient, effective, and accurate manner.

Qualifications:

• High School Diploma (GED) required
• A minimum of 2 years prior experience in a medical records department or like setting preferred
• Must have strong computer software experience – general working knowledge of Microsoft Word and Excel required
• Requires ability to work remotely and at times provide support in client locations.  Geographical proximity to the assigned client site required.
• Excellent organizational skills a must
• Must be able to type 50 wpm
• Must be able to use fax, copier, scanning machine
• Must be willing to learn new equipment and processes quickly.
• Must be self-motivated, a team player
• Must have proven customer satisfaction skills
• Must be able to multi-task

Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.