Chart Retrieval Analyst I

Chart Retrieval Analyst I

SummaCare - 1200 E Market St, Akron, OH

Full-Time / 40 Hours / Days

Hybrid Role

Based in Akron, Ohio, SummaCare 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 2026 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:

Professional analyst to perform essential functions in Risk Adjustment related to provider and member interactions. Performs chart retrieval, medical record tracking, processes invoices / check requests, performs outreach phone calls, ensures data quality oversite while resolving inquires / issues by utilizing exceptional client support to ensure a positive customer experience. 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.

1. Formal Education Required:

a. Associate degree or equivalent combination of education and/or experience.

2. Experience & Training Required:

a. One (1) years of work experience in an administrative support or customer service 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. Strong professional skills to assist provider and members with inquiries, resolving issues and ensuring a positive customer experience.

e. Strong communication skills, especially active listening to confirm the client's needs are heard and understood in order to respond in an appropriate manner to ensure successful outcomes.

f. Strong personal skills to develop long lasting relationships founded on patience, professionalism, and people first attitudes.

g. Has a working knowledge of medical coding concepts, clinical procedural and diagnostic code sets.

h. Maintain current knowledge of, comply with regulatory, and company policies and procedures.

i. Maintain confidentiality of patient and business information.

j. Willing to be trained in technical areas such as SQL Server, SSIS and Business Intelligence tools.

k. Ability to be trained in new functional areas related to risk adjustment such as medical record retrieval, EMR systems and payment forecasting.

l. Demonstrate strong attention to detail and understanding the medical record.

m. 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

$24.93/hr - $29.92/hr