Chart Retrieval Analyst I
SummaCare - 1200 E Market St, Akron, OH
Full-Time / 40 Hours / Days
SummaCare is a Summa Health entity that offers health insurance in northern Ohio. As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.
Summary:
Develop Business Intelligence analytics required to perform essential functions in Risk Adjustment. Performs chart retrieval, medical record tracking, data quality oversite for risk mitigation and revenue recovery for both Medicare and ACA services. Assists in the development and management of activities in support of HCC coding while ensuring compliant practices for revenue management and reducing risk. Supports the Risk Adjustment Data Validations (RADV) audits by ensuring all documents are transferred, logged and archived. Responsible for the delivery of clinical education materials to network providers as well of receiving all necessary medical documentation in support of related risk adjustment activities.
Formal Education Required:
a. Associate degree or equivalent combination of education and/or experience.
Experience & Training Required:
a. One (1) years of work experience in an administrative support role preferred.
3. Other Skills, Competencies and Qualifications:
a. Ability to travel to and from provider on an as needed basis.
b. Demonstrate knowledge of Microsoft Office suite.
c. Organize and manage time to accurately complete tasks within designated periods in fast-paced environment.
d. Has a working knowledge of medical coding concepts, clinical procedural and diagnostic code sets.
e. Maintain current knowledge of, comply with regulatory, and company policies and procedures.
f. Maintain confidentiality of patient and business information.
g. Willing to be trained in technical areas such as SQL Server, SSIS and Business Intelligence tools.
h. Ability to be trained in new functional areas related to risk adjustment such as medical record retrieval, EMR systems and payment forecasting.
i. Demonstrate strong attention to detail and understanding the medical record.
j. Flexible: ability to adjust work hours to meet business demands.
4. Level of Physical Demands:
a. Sit for prolonged periods.
b. Bend, stoop, and stretch.
c. Lift up to 20 pounds.
d. Manual dexterity to operate computer, phone, and standard office machines.
Equal Opportunity Employer/Veterans/Disabled
$21.33/hr - $25.60/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.