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Manager, Medical Records

4 months ago

Wheeling, United States The Health Plan Full time

Under the Direction of the Director, Quality Improvement, the Manager, Medical Records is responsible for overseeing the day to day operations of maintaining, requesting and submitting accurate medical records and member requested information while ensuring compliance and timeliness with all relevant standards and regulations.

Required:

* Minimum of 2 years in a management/supervisory or project management role within managed care, health care setting, or other relevant setting.
* Proficiency in medical records and medical terminology.
* Ability to maintain sensitive information with discretion and professionalism.
* Strong knowledge with HIPAA compliance and other relevant laws/regulations.
* Policy and procedure writing experience.
* Strong communication skills with attention to detail and accuracy.
* Excellent organizational and time management skills.
* Proficient in Microsoft Office Suite products.
* Ability to analyze data and prepare reports as requested.
* Flexibility to adapt quickly to changing priorities to meet deadlines.

Desired:

* Proficiency in medical records systems and record keeping.

Responsibilities:

* Manages the day to day operations of maintaining, requesting and submitting accurate medical records while ensuring compliance and timeliness.
* Supervises medical records staff members in their daily functions.
* Tracks, processes, and evaluates requests for release of member information or requests to obtain member information in a timely manner.
* Develops policies, procedures and protocols for medical record management.
* Gathers data and prepares reports as requested.
* 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.
* Works with business owners to ensure contractual agreements are met in regards to medical record requests for timeliness and payment based on the need of the request.
* Works with Finance, Accounts Payable to reconcile invoices from third party entities for copying services.
* Implements communication processes with requestors regarding status of requests via phone, email, fax or through portal access.
* Oversees and maintains 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.
* Collaborates with the Provider Delivery Services Department to engage with provider offices and facilities that are non-responsive in providing medical records that are being requested.
* Develops departmental desktop procedures and workflows and as well as training material/resources for new department staff.