Medical Records Authorizations Manager

5 days ago


Greenville, United States Wilkinson Staffing Agency Full time

Job Summary:

Ensure accurate and timely processing of medical records and authorizations complying with regulatory requirements.

Key Responsibilities:

Authorizations (80%):

  • Resolve all assigned authorizations promptly.
  • Contact payors for status updates on pending requests.
  • Submit and follow up on at least 10 authorizations daily.
  • Verify patient insurance eligibility and benefits.
  • Communicate procedure and diagnostic codes to obtain correct referrals and authorizations.
  • Coordinate with internal personnel for detailed information.
  • Update parties on insurance or procedural changes.
  • Obtain sameday referrals and authorizations for visits and procedures.
  • Identify primary and additional payers.
  • Work with billing to reconcile authorization discrepancies.
  • Support departmental and corporate strategic plans.
  • Enter clinical and nonclinical data into databases accurately.
  • Respond to calls and emails within 24 hours.
  • Maintain client confidentiality.

Medical Records (20%):

  • Collect organize and maintain medical records.
  • Verify accuracy and completeness of records.
  • Enter patient information into EHR systems.
  • Process medical record requests per HIPAA regulations.
  • Release information to authorized individuals/entities.
  • Perform quality checks and correct discrepancies.
  • Assist with accessing and retrieving medical records.
  • Maintain and update filing systems.
  • Collaborate to facilitate information flow.
  • Ensure compliance with regulations and guidelines.

Education and Experience:

  • High school diploma or equivalent; associate/bachelors in healthcare administration or related field preferred.
  • Minimum 3 years of clinical or related experience.
  • Preferred: Case management utilization review or prior authorization experience.
  • Knowledge of thirdparty payer and NCMedicaid rules preferred.
  • Experience as a Medical Records Specialist or similar role in healthcare.
  • Familiarity with medical terminology anatomy and physiology.
  • Proficiency with EHR systems and medical record software (e.g. Epic Cerner Meditech).
  • Understanding of HIPAA regulations and privacy laws.
  • Strong attention to detail and accuracy.
  • Excellent organizational and time management skills.
  • Effective verbal and written communication skills.

Full benefits after 90 days.

Remote Work :

No


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