Provider Outreach & Medical Records Retrieval Specialist

Position Summary

This position is accountable for physician outreach, relationship management, issue identification, and problem resolution related to the release and retrieval of medical records. The role serves as the primary external-facing member of a cross-functional team supporting the end-to-end provider experience and chart retrieval process throughout New Jersey and surrounding areas.

The position works directly with network physicians, medical practices, and healthcare facilities to facilitate the electronic retrieval or scanning of medical records. It also supports physician education and promotes adoption of Horizon’s Risk Adjustment initiatives while ensuring timely, accurate, and compliant chart collection.

Major Responsibilities

• Serve as the key external-facing member of a cross-functional team responsible for chart abstraction and medical record retrieval for assigned providers and facilities.
• Develop and maintain effective relationships with physicians, healthcare professionals, and members of the broader provider community.
• Educate providers and physicians on Horizon’s chart collection activities and Risk Adjustment initiatives.
• Respond to provider inquiries regarding information and data, resolving issues and supporting increased chart retrieval volumes.
• Educate, monitor, analyze, document, and communicate with physicians and other healthcare professionals to ensure cooperation with chart retrieval projects.
• Identify and escalate potential issues, trends, and opportunities to leadership based on physician and provider interactions.
• Maintain current knowledge of healthcare industry trends and developments through industry publications, newsletters, and formal training.
• Ensure medical records are assembled in the required standard order and are accurate and complete.
• Meet established productivity standards for medical record collection and retrieval.
• Maintain strict confidentiality and security of patient records in accordance with HIPAA and company requirements.
• Receive and process chart requests according to company standards.
• Maintain the integrity of the chart retrieval database and quality audit controls for all medical record documents.
• Ensure all medical record documentation is processed accurately and within required timelines.

Education & Experience

• Bachelor’s degree or relevant experience in lieu of a degree required.
• Minimum of 2 years of healthcare experience required, preferably in a provider-facing or client-facing role.

Licensing & Certifications

• Valid New Jersey driver’s license and good driving record required, subject to New Jersey DMV verification.
• HIPAA Privacy Certification preferred.

Knowledge

• Knowledge of the healthcare industry and provider environment.
• Knowledge of the New Jersey physician community preferred.
• Strong PC skills, including Microsoft Office.
• Basic knowledge and navigation skills with clinical EMR/EHR systems such as Allscripts, Epic, eClinicalWorks, and NextGen are a plus.

Skills & Abilities

• Strong interpersonal and relationship-management skills, including diplomacy, patience, and professionalism.
• Strong time-management and organizational skills.
• Ability to manage and prioritize multiple projects simultaneously.
• Strong communication and problem-solving abilities.
• Ability to work effectively with physicians, healthcare professionals, internal teams, and other stakeholders.
• High attention to detail and commitment to accuracy, confidentiality, and compliance.