Remote Risk Adjustment Coding Jobs in Monroe, GA

The Medical Canvassing Analyst is responsible for conducting high-volume outreach to medical providers, facilities, and related entities to obtain records, verify treatment, and support investigative efforts. This role includes end-to-end execution of assigned medical canvassing and record retrieval tasks, ensuring timely follow-up, accurate documentation, and compliance with all applicable requirements.

The role requires the ability to review client requests and available information to determine appropriate canvassing strategies, as well as analyze findings to identify inconsistencies, undisclosed treatment, or gaps in reported medical history. The Medical Canvassing Analyst operates in a production-driven environment with a focus on efficiency, accuracy, and quality.

Essential Duties and Responsibilities

The Medical Canvassing Analyst is responsible for the following core duties and accountabilities, which are essential to the successful performance of the role:

Case Execution, Canvassing & Record Retrieval

• Review client requests and available information to determine appropriate providers, facilities, or sources to contact, ensuring effective canvassing strategy
• Conduct high-volume outbound calls to medical providers, facilities, and related entities
• Conduct outreach and record retrieval activities in compliance with company policies and HIPAA requirements
• Perform medical canvassing and manage end-to-end record retrieval activities, including initiating requests, conducting follow-ups, tracking status, and coordinating with providers or third parties through completion
• Meet or exceed productivity expectations, including volume, retrieval completion, and turnaround time (TAT) standards
• Manage assigned workload to ensure timely completion of canvasses and record retrievals

Documentation and Quality Assurance

• Accurately document all findings, call outcomes, and retrieval activity in case management systems
• Ensure all records obtained are properly logged, organized, and linked to the correct case
• Maintain complete and audit-ready documentation for both canvassing and retrieval activities
• Perform follow-up actions to resolve incomplete, delayed, or inconsistent information
• Ensure all activities comply with applicable privacy laws and regulations, including HIPAA, when handling protected health information
• Maintain confidentiality and safeguard sensitive information during outreach, documentation, and record retrieval processes
• Analyze canvassing and retrieval results to identify inconsistencies, undisclosed treatment, or gaps in reported medical history, and ensure findings are clearly documented

Issue Identification & Escalation

• Identify potential discrepancies or red flags and escalate findings as appropriate
• Identify delays, non-responsive providers, or barriers to record retrieval
• Escalate complex retrieval issues, missing records, or high-risk concerns as appropriate
• Flag trends or recurring issues impacting retrieval timeliness or success rate

Collaboration & Operational Support

• Coordinate with internal teams or vendors involved in the retrieval process
• Adapt to workload adjustments and shifting priorities as directed
• Adapt to changing priorities, including spikes in case volume

Required Qualifications

• High School Diploma or equivalent
• Strong verbal communication skills, including the ability to conduct professional outbound calls
• Basic analytical skills with the ability to review information and identify discrepancies or gaps
• Strong attention to detail and accuracy in documentation and data entry
• Proficiency in Microsoft Office (Outlook, Excel, Word) and case management systems
• Ability to work independently in a fully remote environment
• Experience with outbound calling or customer interactions in a professional setting
• Demonstrated ability to manage workload, meet deadlines, and maintain productivity standards
• Ability to handle sensitive or confidential information with professionalism
• Ability to follow structured workflows while applying basic judgment and decision-making
  

Preferred Qualifications

• 1-3 years of experience in a high-volume, production-based environment
• Experience with medical canvassing, record retrieval, or healthcare-related environments
• Familiarity with medical terminology or healthcare provider interactions
• Exposure to compliance or privacy requirements (e.g., HIPAA)
• Prior experience in insurance, investigations, or claims-related environments that work with case management systems or investigative tools

Physical Requirements and Environmental Requirements

• Must be able to remain in a stationary position for up to 8-10 hours at a time.
• Must be able to lift to 15lbs.
• Mut be able to verbally communicate clearly and hold regular conversations on the phone and through virtual platforms.
• Ability to operate a computer and other office productivity machinery.
  

Work Schedule

Monday-Friday 10am-7pm EST

Work From Home Opportunity

Full-time

About the Company

Delta Group is a privately held, national investigative firm established in 1983 and headquartered in Buford, Georgia. As pioneers of unmanned surveillance technology, Delta Group's eRemote technology is an industry recognized product that continues to evolve and produce game-changing results. With more than 500 direct employees nationwide, our domestic footprint is large enough to matter and small enough to care.

We pride ourselves on developing and retaining professional staff while maintaining diversity within our team. Our executive leadership team brings over 100 years of combined experience leading national carrier fraud divisions, state fraud prosecutorial offices, claims and program management divisions, and investigative operations.

For over 41 years, our investigative resources have helped organizations reduce risk, improve profitability, and increase revenue within the insurance industry. Our expert employees are located throughout the United States, executing investigations for all types of claims including but not limited to, workers' compensation, liability, auto, property, disability, and corporate investigations, regardless of size. Come join our talented team and our commitment to people, innovation and results.

Delta Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex (including pregnancy, sexual orientation, gender identity / expression), national origin or ancestry, genetic information (including family medical history), physical or mental disability, protected veteran status, or any other characteristic protected under federal, state or local law, where applicable, and those with criminal histories will be considered in a manner consistent with applicable state and local laws.