Intake - Chart Retrieval Associate II (Fixed Term Employment)

The Intake – Chart Retrieval QRM Associate is responsible for reviewing, validating, and processing medical records to support quality review and case management activities. This role requires a high level of attention to detail, strong analytical skills, and the ability to work efficiently across multiple applications while ensuring compliance with HIPAA, client requirements, and NCQA standards.

• Collaborate closely with Registered Nurses (RNs), Medical Coders, and multidisciplinary healthcare professionals to ensure seamless communication and accurate case management
• Review retrieved medical records to verify that they are legible, complete, and accurately matched to patient identifiers, including name, date of birth, dates of service, provider, and facility information
• Handle all Protected Health Information (PHI) with strict confidentiality while ensuring full compliance with HIPAA regulations and client security protocols
• Analyze received medical records and file data to determine the appropriate clinical pathway and next steps
• Route cases to the appropriate clinicians based on urgency levels (urgent versus non-urgent) to ensure adherence to established turnaround times (TATs) and NCQA standards
• Maintain accuracy and consistency when working with patient records and clinical documentation across various Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems
• Utilize Microsoft Excel to organize and maintain departmental files, track case status, and produce accurate weekly reports
• Perform quality checks to ensure medical records meet client and organizational requirements
• Manage multiple priorities and applications while maintaining productivity, accuracy, and service-level expectations

Qualifications:

• Any college education
• At least 6 months of Healthcare BPO work experience
• Ability to multitask across multiple applications
• Strong analytical skills with excellent attention to detail
• Great team player with excellent interpersonal skills
• Amenable to 6 months contract

Successful hires will be asked to provide NBI clearance, Former Employment documents among others