[Hiring] Chart Procurement Analyst @Arkansas Blue Cross Blue Shield

Role Description

The Chart Procurement Analyst coordinates the retrieval of medical records for initiatives related to risk adjustment, documentation and coding accuracy, and quality measures. The incumbent is responsible for collecting, organizing, and analyzing medical records data, which includes:

• Using provider information to create reports about streamlining the collection and internal sharing of patient records.
• Acting as a liaison between healthcare organizations, copy service vendors, internal departments, and the risk adjustment team.
• Working closely with provider network, collaborative health integration, primary care, and quality departments to ensure program efficiencies and streamlined provider communication, collaboration, and education as applicable.

Qualifications

• Bachelor's degree in Business or Healthcare management related field. In lieu of degree, five years’ health-related non-clerical experience with an insurance, managed care, or healthcare organization will be considered.
• Minimum three (3) years' analysis, research, and/or medical coding experience.
• Minimum two (2) years' medical record review experience.
• Knowledge of EMR (Electronic Medical Records) systems or electronic data sources.
• Knowledge of HL7, FHIR, etc. preferred.
• Knowledge of Risk and Quality concepts related to Medicare Advantage and Affordable Care Act populations preferred.
• Knowledge of Visio or flowcharting software preferred.

Requirements

• Organizational Planning
• Interpersonal Communication
• Microsoft Excel
• Reasoning
• Analyze Information
• Active Listening
• Motivated self-starter
• Electronic Medical Record (EMR) software
• Medical Record Reviews
• Proficiency working with MS Office Suite, such as Word, Excel, and PowerPoint.
• Proficiency with MS Access, MS Project, and SharePoint software preferred.

Benefits

• Work from home within Arkansas
• Work Schedule: M-F
• Some local travel may be necessary to go to provider offices to retrieve records.

Responsibilities

• Assists providers with the process of sending medical records.
• Assists with risk adjustment business analytics and/or medical coding, which requires the attainment of specialized certifications, training, and education.
• Collaborates with internal departments, medical offices, and copy service vendors.
• Develops and maintains tools to assist with retrieval efforts and researches solutions for retrieval roadblocks.
• Identifies process improvement opportunities.
• Retrieves, analyzes, coordinates, monitors, and conducts reporting of medical records to ensure success of chart retrieval aspects.
• Other duties as assigned.

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of the location of primary work assignment.