Billing and Medical Record Analyst

Acadia Healthcare • Franklin, TN

15d • Remote

About The Position

Reporting to the Director – Compliance Auditing and Monitoring, the Medical Record Analyst serves as the subject matter expert for medical record reviews as it relates to clinical and financial components of the patient record including, medical necessity, quality documentation requirements. T he Medical Record Analyst collaborates with CTC Group Operational Leadership and CTC Business Office to assist with external reviews and/or audits from third party payors and governmental agencies. The Medical Record Analyst will trend findings from both internal and external reviews/audits to assist with standardizing best practices and training needs of the CTC Group programs.

Requirements

• Minimum of 4 - 5 years’ experience within the outpatient behavioral and substance use disorder (SUD) healthcare is required
• Previous experience with a proprietary healthcare system highly preferred.
• Demonstrates strong healthcare billing and coding aptitude and possesses associated technical skills.
• Experience working with IT and proficiency with software packages including Excel
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to the next level.
• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
• Excellent interpersonal skills include the ability to interact effectively and professionally with individuals at all levels; both internal and external.
• Strong communications skills - both written and verbal.
• Self-motivated with the ability to work independently with strong organizational skills and superior attention to detail.
• Must be able to manage multiple tasks/projects simultaneously within inflexible time frames.
• Ability to adapt to frequent priority changes.
• Capable of working within established policies, procedures and practices prescribed by the organization.
• English sufficient to provide and receive instructions/directions.

Nice To Haves

• CPC – Certified Professional Coder (preferred)
• CCS – Certified Coder Specialist (preferred)
• RHIT – Registered Health Information Technician (preferred)
• RHIA – Registered Health Information Administrator (preferred)

Responsibilities

• Responsible for gathering, reviewing, and submitting all requested and/or required documentation to fulfill medical record requests
• Tracking and processing of medical record requests; post payment reviews from third party payors and government entities
• Communicates with third party insurance carriers/government agencies to verify medical record content requirements and timelines
• Coordinates with the clinic and CBO teams to track pre-payment reviews to identify trends/risks and report and escalate to leadership
• Collaborates with CTC Group operational and business office leadership on all payor and governmental agency requests for records
• Communicates with clinic team and operational leadership when medical record requests are received
• Assists with review of audit findings and development of audit appeals as needed
• Communicates findings to leadership and make recommendations for improvement in processes or EMR functionality based on audit findings
• Provides monthly and quarterly reports on review trends based on medical record requests and audit findings
• Maintains effective communication with third party insurance carriers to resolve issues identified during the audit process
• Maintains knowledge of industry standards and trends including CPT, ICD-10 and Medicare/Medicaid guidelines
• Provides feedback and recommendations on medical record process improvement
• Performs other duties as assigned
• Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
• Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team.
• Develops constructive and cooperative working relationships with others and maintains them over time.
• Encourages and builds mutual trust, respect and cooperation among team members.
• Maintains regular and predictable attendance.

Benefits

• Comprehensive Medical, Dental, & Vision insurance
• Competitive 401(k) plan with company match
• Company paid group term life insurance and short-term disability
• Generous PTO: Paid vacation, personal time, sick Leave, and extended sick leave
• Employee Assistance Program (EAP) offering continued support to employee lifestyle and well-being
• Career advancement opportunities across a leading national network

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees