About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

Blue Cross and Blue Shield of Minnesota is hiring a Senior Medical Record Retrieval Operations Specialist. This position supports the team with primary accountabilities related to quality improvement, Medical Records Review (MRR), and provider outreach and relations. This position will coordinate and implement activities supporting accurate and timely document management and retrieval efforts, adherence to regulatory and project timelines, improved delivery of clinical care, and protection of PHI. This position collaborates with multiple stakeholders at many levels across the company, as well as with external entities, providing coordination and support as required.

Your Responsibilities

• Coordinate and track process flows. Review initiatives, ensuring process timeliness, information accuracy, and compliance with processes to protect PHI. This includes managing requests and documents such as Medical Records and Release-of-Information, as well as providing contributions to the production of an accurate, validated final audit result reporting.
• Assist quality assurance team and providers to troubleshoot any logistical or technical issues regarding records requests and management.
• Manage and implement communications processes for the annual HEDIS Medical Records Review initiative including clinic information updates, committee reports, article submissions, and distribution of communication materials to providers, ensuring adherence with challenging project timelines. This will include direct outreach to provider clinics to develop relationships and update information.
• Participate in clinical quality improvement projects, including implementation and execution of interventions such as member mailing campaigns, the distribution of provider materials, and other activities as required for project success.
• Manage and maintain Medical records repository for the department. Ensure accuracy, timeliness of record uploads, compliance with processes to protect PHI, and effective tracking of records and record requests.
• Assume a key role in the development of new processes and tracking systems to support best practice record keeping and document management procedures. Coordinate and tracks process flows for received complaints, ensuring compliance with regulatory deadlines, protection of PHI, and reliable follow up. Identify process issues and contribute to the design of solutions. Proactively implement process improvements.
• Complete additional tasks as required to coordinate activities for and/or implement improvements to the quality of clinical care or to processes supporting the measurement of clinical quality.

Required Skills and Experience

• 5+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Related experience may be in roles involving coordination, organizing documents and/or information, tracking data or processes.
• Team player orientation with ability to build and maintain relationships with cross-functional business partners, external partners, and others.
• Highly developed diplomatic and interpersonal communication skills.
• Strong organizational skills, ability to prioritize responsibilities with attention to detail.
• Must be self-motivated, able to take initiative, and work independently with minimal oversight to meet timelines.
• Strong follow-through skills and a solutions-oriented attitude.
• Detail oriented, with the ability to organize and track information and documents, to prioritize and maintain timelines, and to improve processes.
• Ability to work at a fast pace under pressure, meeting multiple deadlines and in multiple systems simultaneously.
• Experience in using Microsoft Excel and Word, and demonstrated ability to learn/adapt to computer-based tracking and data collection tools.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Associate's degree.
• RHIT Certification.
• Health Care or Health Plan experience.
• Experience with Medical Records or in a Clinical setting.
• Experience in using Adobe Pro.
• Experience in using Microsoft Access.
• Experience in using multiple software programs to complete a process

Compensation and Benefits:

Pay Range: $23.10 - $28.88 - $34.66 Hourly

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Role Designation

Hybrid

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week – most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.