Medical Records Specialist

• Medical Records & ROI Workflow Management: Oversee Release of Information (ROI) end-to-end processing, managing incoming and outgoing requests via modern EHR and health information exchange (HIE) platforms, ensuring timely and compliant release to insurance companies, patients, legal entities, and authorized third parties.
• HIPAA, Audit Readiness & Data Privacy Protocols: Maintain full audit readiness and adherence to HIPAA rules, state regulations, and internal privacy policies when handling, releasing, auditing, and archiving protected health information (PHI).
• Strategic Payer Follow-up: Proactively track remits and engage with insurance payers to resolve outstanding issues and ensure timely reimbursement.
• Cross-Functional Collaboration: Collaborate with internal teams to coordinate patient insurance updates, manage claim hold protocols, and support resolution of claim-related issues.
• Queue Management: Effectively prioritize and manage assigned responsibilities within revenue cycle operations while maintaining accuracy and efficiency.
• Revenue Lifecycle Management: Assist with claim submission, adjudication, payment posting, and patient account reconciliation as needed.
• Quality Control: Audit claims for appropriate modifiers and correct billing data points prior to transmission.

Qualifications

• Education: HS Diploma required; Degree in progress or completed preferred.

• Experience: 2 years of Medical Billing/RCM experience (preferred).

• Skills:

• Deep understanding of medical billing/coding and EMR systems.

• Proficiency in office technology and multi-line phone management.

• Exceptional organizational skills with high attention to detail.

• Strong interpersonal skills for effective team and patient communication.