Medical Records Specialist

Job Title: MEDICAL RECORDS SPECIALIST Department: MEDICAL RECORDS

Reports to: MEDICAL RECORDS SUPERVISOR Effective Date: 01/17/2025

Job Summary:

The Medical Records Specialist manages medical records requests, ensuring compliance and accuracy while handling inbound and outbound requests. This position is responsible for preparing chart notes, processing referrals, maintaining provider databases, and coordinating correspondence with referring providers and healthcare organizations.

This role also supports administrative tasks such as scanning, faxing, processing postal mail, and managing digital records. This position requires strong communication skills, ability to work efficiently in a fast-paced environment, attention to detail and good organization skills.

Responsibilities:

Correspondence & Letter Processing:

• Complete transfer of care letters for patients being released back to their referring provider, including faxing required documents.

• • Maintains the comanaged care spreadsheet, ensuring all necessary patients are documented and tracked.

• Process and send letters related to diabetic eye exams when necessary

• Send follow-up letters to referring providers when patients cannot be scheduled due to no contact or insurance issues.

Medical Records:

• Process inbound and outbound medical records requests via fax, postal mail, email and in person, ensuring compliance with policies and regulations.

• Complete medical records correspondence with Kaiser via fax or courier.

• Prepare and send appropriate chart notes and diagnostic imaging as requested.

• Follow proper invoicing protocols for records requests involving fees (e.g. attorney requests).

• Retrieve and access records from current and former E.H.R. systems.

• Maintain and update external provider database information in E.H.R. and Practice management systems.

• Pickup and deliver interoffice documents, ensuring timely distribution of route slips and emptying provider outboxes.

• Monitor and manage digital fax system.

• Retrieve archived paper charts from storage as needed.

Referrals:

• Process referrals from external providers, including:

• • Creating or updating patient accounts.

• • Scheduling appointments and verifying insurance.

• • Contacting referring providers for additional information when necessary.

• • Uploading referral documentation into practice management system.

• Enter referrals into referral management system when submitted through non-standard methods (e.g., fax or patient contact)

Administrative Support:

• Provider backup support to Patient Service Representatives and Cataract Referral Coordinator

• Assist with inbound mail sorting and distribution.

• Monitor and respond to emails, including group medical records emails.

• Monitor the provider phone line.

• Other duties as assigned.

Required Skills/Abilities:

• Strong understanding of insurance coverage, authorizations and referrals.

• Proficiency with practice management systems and electronic health records (E.H.R.)

• Proficient in Microsoft Office Suite (Word, Excel, Outlook, Teams, SharePoint).

• Ensures confidentiality of information by following HIPAA/HITECH policies and regulations.

• High level of initiative, judgment, discretion and decision-making skills.

• Strong organizational and prioritization abilities.

• Excellent written and verbal communication skills, including grammar and spelling.

• Exceptional attention to detail.

• Professional demeanor with strong customer service and interpersonal skills.

• Ability to work efficiently in a fast-paced, evolving environment.

Education and Experience:

High school diploma or equivalent required; associate degree in related field preferred.

Minimum of 1 year in healthcare administrative role; ophthalmology experience preferred.

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer.

Requires periods of standing and walking.

Requires ability to use telephone and radio.

Must be able to go up and down stairs.