Medical Records Clerk

Job Description

Job Description

Description :

SUMMARY OF RESPONSIBILITIES

The position of Medical Records Specialist is responsible for processing all billable requests from third party requestors. Serves as a backup when other medical follow specialists or payment posters are out to ensure seamless flow of department.

ESSENTIAL FUNCTIONS

1. Processes all billable requests and log them into the system Invoice and / or pre-bill requests. Billable requests are defined as those requests by a third-party requestor, including but not limited to, attorneys, insurance companies, government agencies and patients who are billed as provided by state and / or federal laws.

2. Process non-billable requests. Non billable requests are defined as requests by internal departments, patient transfers and continuing care which are not historically billed, and payment of claim managed care organizations and / or health plan requests.

3. Copy Quality Improvement Organization and / or Peer Review Organization requests.

4. Review requests and verify authorizations in accordance with PTCOA policy and all applicable state and federal laws.

5. Determine the correct amount to charge third party requestors.

6. Look up patient ID via EMR system

7. Retrieve charts for pertinent information.

8. Provide follow-up as necessary regarding incomplete requests; send out status letters.

9. ePrint, prepare certification for requested records.

10. Return records to their original order.

11. Ensure records are organized, accurate, and complete

12. Create digital copies of paperwork and store records electronically.

13. Filing paperwork and reports of inpatients quickly and accurately.

14. Safeguarding patient records and ensuring HIPAA compliance.

15. Transfer data into PTCOA main system database.

16. Process the records for admitting and discharging patients.

17. Performs other related duties as required.

Requirements : CORE COMPETENCIES

• Record / report the need for service maintenance or repair of equipment and remove any faulty equipment from service.
• Ability to prioritize and manage multiple tasks without direct supervision.
• Multi-tasking abilities, along with ability to work well under pressure, prioritize and meet tight deadlines.
• Must be able to work independently in a fast-paced environment and exhibit strong written and verbal communication skills.
• Strong customer service and prompt problem-solving skills including the ability to provide diligent, prompt, and courteous responses to user questions or computer / network issues.
• Consistently evaluate work completed and determine if further steps are needed to meet client expectations.
• Take initiative to do to redo inadequate or incomplete work, even if it is not yours.
• Ensure compliance with regulatory standards.
• Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
• Minimize non-productive time and fill slow periods with activities that will enable you to prepare to meet the future needs of the company (education, organizing, housekeeping, assisting others).
• Organize job functions and work area to be able to effectively complete varied assignments within established time frames.
• Consistently demonstrate ability to take the initiative to make decisions / choices without direct supervision.
• Adhere to administrative and departmental policies.
• Demonstrate regular attendance and timeliness.
• Do not incur excessive overtime.
• Remain conscientious in regard to personal hygiene.
• Demonstrate knowledge and understanding of all policies and procedures and ability to reference them from appropriate sources.
• Demonstrate adherence and support of company-wide service standards as evidenced by observation and feedback from patients, family members, and other clients.

REQUIRED EDUCATION, EXPERIENCE, AND / OR CERTIFICATIONS

The position requires a high school diploma or educational equivalent and one (1) year of experience in healthcare insurance verification or medical authorization or the equivalent.

WORKING ENVIRONMENT AND PHYSICAL DEMANDS

This is a part-time position. Days and hours of work are expected to include 8 : 00 a.m. to 5 : 00 p.m Monday-Friday. Occasional overtime may be required. The position operates in a professional office environment and the incumbent, in the course of performing this position, spends time writing, typing, speaking, listening, driving, seeing (such as close, color and peripheral vision, depth perception and adjusted focus), sitting, walking, standing, and reaching. The incumbent may operate any or all of the following standard office equipment including but not limited to multi-line telephone system, postage mater, facsimile machines, calculator, photocopy machine, computer / printer, and coffee maker. The work environment characteristics and physical demands described here are representative of those an employee encounters while performing the essential functions of this job.