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Medical Record Field Reviewer

Change Healthcare • Boston, MA

Posted 7 days ago

Job Snapshot

Full-Time
Healthcare - Health Services, Pharmaceutical, Managed Care
Health Care, Nurse, Pharmaceutical

Job Description

Medical Record Field Reviewer Position Description

Change Healthcare Company is a total solutions partner for healthcare data auditing and analytics.  Change Healthcare provides end-to-end solutions to help improve payment integrity data to support accreditation programs, and meet regulatory requirements.  Change Healthcare’s nationwide network of registered nurses, certified coders and medical professionals work to acquire, audit, and analyze data for healthcare organizations.  We specialize in: CMS-HCC Risk Adjustment, HEDIS Medical Record Reviews, Accreditation and more.

Regarding the Position
 
The Project the Field Reviewer would be hired is titled “HEDIS or PIA.”  HEDIS (Healthcare Effectiveness Data Information Set) is a review “Report Card” for Health Plans to ensure they are providing the quality care and services to the members they insure.  PIA (Payment Integrity Audit) ensures that Health Plans are billing correctly through the Centers for Medicare Medicaid.
 
We hire RNs, LPNs, Certified Coders, RHIT or RHIA, Medical Assistants, Certified Nursing Assistants and other healthcare professionals to work as Medical Record Reviewers (Field Reviewers).  We also consider Medical Records professionals that have a minimum of two (2) years hands on medical records experience EMR, EHR experience a plus.  
 
Field Reviewers visit physicians' offices to retrieve and review specific requested documents from medical records.  A Field Reviewer Advocate is assigned to help plan daily activities and manage work flow. Change Healthcare will schedule and confirm appointments to ensure efficiency.  Computer equipment is provided for scanning charts and transferring files to our secure file transfer site.  Help Desk assistance for both IT support and medical record retrieval is available.  We offer competitive wages, provide thorough training in the use of our technology, and HIPAA compliance training.

Job Requirements

Summary of Responsibilities

 

  • Travel to medical facilities or provider offices in specified areas to complete review services.
  • Communicate effectively and professionally with care provider offices, clinics, hospitals, other clinical facilities.
  • Accurately and efficiently manage paper medical records, or an EMR/EHR platform to retrieve information.
  • Scan relevant components of the medical record to support reviews performed.
  • Upload extracted medical records per assignment.
  • Maintain quality and production standards required by company.
  • Report work-related concerns to assigned Field Reviewer Advocate and the established escalation chain as needed.
  • Comply with HIPAA laws and regulations.
  • Present a professional appearance and attitude when on assignment. Business attire is required for all appointments.

Qualifications

  • Must be an RN, LPN, LVN, Certified Coder, RHIT, RHIA, CNA, MA or Medical Records professional with a minimum of at least two years of direct medical record and HR/EMR experience.
  • Must be familiar with how to identify a medical record and the corresponding components.
  • Must be willing to travel within a 40-mile radius. Radius requirements are firm however, we do take into consideration any geographical constraints that would hinder complete radial coverage.
  • Must be able to meet tight deadlines and work effectively without direct supervision.
  • Must have reliable transportation, auto insurance and valid driver's license. Exceptions may be allowed in certain metropolitan areas.
  • Must have a working knowledge of HIPAA requirements, recognizing a commitment to privacy, security and the confidentiality of all medical chart and patient health information.
  • Must be computer literate and technologically savvy. The ideal candidate should be comfortable with Windows navigation (START menu/opening folders), Microsoft Office (Word/Outlook), cutting/pasting files and working with flash drives.
  • Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better and a mobile phone.
  • Must have strong interpersonal, customer service and communication (written and oral) skills.
  • Must be available to work at least (24) hours per week during business hours of 8am-5pm.

 

This is a non-clinical position.  Work is project based and is not considered to be full-time permanent employment.

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