Under the supervision of the Manager, Medical Records is responsible for requesting, filing and maintaining, and submitting accurate medical records and member requested information while ensuring compliance and timeliness with all relevant standards and regulations.
Required:
High school diploma or equivalent.
Demonstration of proficient organizational skills and clerical skills with typing and filing.
Ability to maintain sensitive information with discretion and professionalism.
Strong knowledge with HIPAA compliance and other relevant laws/regulations.
Strong communication skills with attention to detail and accuracy.
Excellent time management skills with the ability to adapt quickly to changing priorities to meet deadlines.
Desired:
Proficiency in medical records systems and record keeping.
Experience in medical records and medical terminology.
Responsibilities:
Processes requests for release of member information or requests to obtain member information in a timely manner
Enters medical record requests into a shared data base for tracking and trending
Requests medical records by fax, telephone, or third party vendor with applicable turnaround times dependent upon the reason for the request
Follows up on medical record requests to assure timeliness of requests for audits and regulatory oversight
Works fax queues to and copying service queues and downloads medical records to appropriate areas
Adheres to correct file naming conventions for medical records
Reconciles copying service invoices as directed
Attaches invoices to Accounts Payable folders as directed who are maintaining, requesting and submitting accurate medical records while ensuring compliance and timeliness
Processes requests for release of member information or requests to obtain member information in a timely manner
Adheres to policies, procedures and protocols for medical record management
Assists with gathering data and preparing medical record reports as directed by manager
Ensures that each member's record is maintained in a confidential and secure manner
Ensures the accuracy and accessibility of member medical records once received
Implements communication processes with requestors regarding status of requests via phone, email, fax or through portal access
Navigates multiple portal queues for medical record requests
Requests, retrieves, files and attaches medical records as outlined in policies and procedures
Processes other applicable incoming correspondences as needed
Sends follow up responses to internal staff making the requests as well as to those that have not complied with meeting the request.
Communicates to manager the need to notifiy the Provider Delivery Services Department to engage with provider offices and facilities that are non-responsive in providing medical records that are being requested
8:00 am - 5:00pm
40
Numbers & Facts
Location
Wheeling, WV
Industry
Insurance
Company Size
500 to 999 employees
About Company
The Health Plan, established in 1979, is one of the largest locally managed care organizations in Ohio and West Virginia, serving over 350,000 covered lives. As a federally qualified and state certified 501 (c)(4) not-for-profit HMO, our goal is to provide high quality, comprehensive, and cost-effective health care. Our self-funded division, available in all 50 states, is the fastest growing product within in the organization offerings. The Health Plan is an established and financially secure organization and West Virginia's first and largest HMO.
Skills
Accounts Payableunmatched
Billingunmatched
Communication Skillsunmatched
Data Collectionunmatched
Detail Orientedunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
High School Diplomaunmatched
Maintain Complianceunmatched
Medical Office Administrationunmatched
Medical Protocolsunmatched
Medical Record Systemunmatched
Medical Recordsunmatched
Medical Terminologyunmatched
Medical Treatmentunmatched
Record Keepingunmatched
Records Managementunmatched
Regulationsunmatched
Time Managementunmatched
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