Retrieves clinical records from EHR systems, manages chart-request queues, verifies document quality and metadata, and supports healthcare data operations. The role also coordinates EHR access, tracks completion goals, manages disenrollments, and protects protected health information under HIPAA guidelines. Candidates need healthcare administration experience, knowledge of Texas Medicaid eligibility rules, and proficiency with state Medicaid portals.
Job Summary: We are seeking a detail-oriented analyst who will be responsible for executing critical medical record retrieval activities in support of risk adjustment and payment integrity functions. The goal is to ensure all stakeholders have access to the right clinical data at the right time to best serve our members and the organization.
- Monday–Friday shift, 8:00 AM ET to 5:00 PM ET
- Wednesday–Sunday shift, 8:00 AM ET to 5:00 PM ET
Supervisory Responsibilities:
This position has no direct supervisory responsibilities.
Duties/Responsibilities:
- Manage a daily queue of chart requests that require logging into EHR (Electronic Health Record) systems and retrieving the necessary clinical information requested from the stakeholder team.
- Ensure that retrieved documents are of high quality, include necessary meta-data, and are readily available for teams to leverage in support of our members.
- Support the manager and internal teams in additional tasks that may include, but are not limited to, requesting EHR access for other team members, managing disenrollments from EHRs, tracking progress toward completion goals.
- Maintain professionalism and respect the privacy of the individuals in the requests. This role has direct access to PHI and therefore must be diligent in maintaining the confidentiality of the members following HIPAA guidelines.
- Perform other duties as assigned.
Required Skills/Abilities:
- High school diploma or equivalent
- General understanding of the U.S. healthcare system and/or a strong willingness to learn
- Detail oriented and motivated to complete tasks with precision and on time
- Inquisitive mindset: not afraid to ask questions and/or clarify instructions, especially the “why”
Education and Experience:
- High School Diploma or equivalent required; Associate's or Bachelor's degree preferred.
- 1+ years of experience in healthcare administration, eligibility verification, or a related field.
- Strong knowledge of Medicaid eligibility rules and regulations in Texas.
- Proficiency in navigating state Medicaid eligibility portals (Texas Medicaid Client Portal, TexMed Connect).
- Experience with healthcare data systems (e.g., Orinoco, Change Healthcare) preferred.
Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift to 15 pounds at a time.
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