Medical Records Specialist

Job Summary: The Verification of Benefits Specialist is responsible for verifying and confirming the benefits and coverage provided by a patient’s insurance plan. This includes ensuring that the services a patient is scheduled to receive are covered under their plan and determining the necessary information to process claims efficiently.

Key Responsibilities

• Record Management:
• Organize and file patient medical records in both paper and electronic formats.
• Update and maintain patient files, ensuring information is accurate and up to date.
• Retrieve patient records upon request by medical staff or authorized personnel,
• Confidentiality and Compliance:
• Ensure that patient records are kept confidential in accordance with HIPAA (Health Insurance Portability and Accountability Act) and other privacy regulations.
• Secure and safeguard all medical records, both physical and electronic, to prevent unauthorized access.
• Data Entry
• Input new patient data, medical history, and treatment information into electronic health record (EHR) systems.
• Perform accurate data entry of medical codes, diagnoses, and other pertinent information into databases.
• Coordination:
• Coordinate with medical personnel, including doctors, nurses, and other healthcare professionals, to ensure proper handling and processing of records.
• Respond to requests from patients or other healthcare providers for medical records.
• Record Retrieval and Disposition:
• Retrieve records for patient appointments, procedures, or legal purposes.
• Dispose of outdated or unneeded medical records in accordance with healthcare regulations.
• Customer Service:
• Assist patients in requesting copies of their medical records and provide instructions on how to obtain them.
• Answer phone calls and respond to inquiries related to patient records.
• Filing and Documentation:
• Maintain accurate logs of patient record requests and provide reports when necessary.
• Ensure records are filed correctly, preventing errors and misplacement.
• Compliance and Reporting:
• Stay updated on regulatory changes related to medical records and data management.
• Help with audits or reviews of patient files to ensure compliance with legal standards.
• High school diploma or equivalent; some positions may require an associate or bachelor’s degree.
• Previous experience in medical insurance verification, billing, or coding is preferred.
• Knowledge of insurance terminology and procedures.
• Familiarity with medical billing software and Electronic Health Record (EHR) systems.
• Strong communication skills, both written and verbal.
• Attention to detail and strong organizational skills.
• Ability to handle sensitive patient information confidentially.
  
  

Skills

• Strong organizational and time-management skills.
• Attention to detail and accuracy.
• Knowledge of medical terminology and coding (ICD, CPT).
• Familiarity with medical records software (EHR/EMR systems).
• Strong communication skills for working with medical staff and patients.