Document Retrieval Specialist

Vālenz Health® is the destination for employers, brokers, payers, and providers to reduce costs, improve quality, and elevate the healthcare experience. Through advanced technology and clinical expertise, Valenz creates a distinctly different approach to a complex healthcare system. With our solutions, we execute across the entire healthcare journey — from member experience to payment integrity, provider quality, and plan performance. With one of America’s largest cost, quality and utilization datasets, we create greater transparency, flexibility, and cost containment — empowering members and employers with the information they need to make smarter, more cost-effective decisions.

As a Document Retrieval Specialist (aka Intake Coordinator for Bill Review), you’ll support the Bill Review process by accurately entering, reviewing, and validating healthcare claim information and supporting documentation. You’ll serve as an initial quality checkpoint, ensuring claims are complete, accurate, properly documented, and ready for downstream review and processing. You’ll also research discrepancies, obtain missing documentation or provider information as needed, and maintain accurate records while meeting established productivity, quality, and turnaround expectations.

• Enters and maintains healthcare claim information in internal systems, including patient demographics, provider information, claim details, diagnosis and procedure codes, charges, dates of service, and supporting documentation.
• Reviews incoming claims and documentation for completeness, accuracy, and consistency before advancing information through the Bill Review process.
• Validates entered data against source documents and performs quality checks to identify and correct errors before downstream processing.
• Identifies missing, incomplete, duplicate, or conflicting claim information and follows established procedures to resolve or elevate discrepancies.
• Researches claim and provider discrepancies using available systems, reports, documentation, and other appropriate resources.
• Contacts healthcare providers as needed to obtain missing documentation and verify provider information necessary to complete claim intake.
• Maintains accurate claim records, notes, and supporting documentation, including corrections, information requests, and actions taken.
• Updates records when corrected or additional information is received and ensures changes are accurately reflected within applicable systems.
• Applies working knowledge of healthcare terminology and claim data elements, including ICD-10, CPT/HCPCS, revenue codes, and related billing information.
• Follows established workflows, standard operating procedures, client requirements, and processing guidelines when completing claim intake activities.
• Tracks completed and outstanding work to ensure assignments are processed within established service levels and turnaround times.
• Meets established productivity and quality expectations while maintaining a high level of accuracy and attention to detail.
• Communicates with internal teams when missing information, discrepancies, or other issues may affect downstream claim processing.
• Identifies recurring data or process issues and communicates trends to leadership to support accuracy, efficiency, and process improvement.
• Participates in training and ongoing education related to healthcare claims, systems, client requirements, procedures, and regulatory standards.
• Maintains confidentiality of protected health information and complies with HIPAA, privacy, security, and organizational requirements.

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

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