Dir. Medical Records

Pinnacle Treatment Brand • ,

2d • Remote

About The Position

Pinnacle Treatment Centers is a growing provider of addiction treatment services, serving more than 30,000 patients daily. Its mission is to remove barriers to recovery and help individuals, families, and communities through effective treatment.

The Director of Medical Records oversees the medical records function and serves as the enterprise-wide Corporate Custodian of Records. This includes developing policies and procedures; supervising staff; managing records requests, subpoenas, and court appearances; maintaining and transferring records; and ensuring compliance with HIPAA, 42 CFR Part 2, and applicable laws and regulations. The role also oversees off-site storage vendors and ensures that stored records meet legal, regulatory, company, and contractual requirements.

This position is remote and requires a minimum of five years of electronic medical records experience, HIPAA Privacy Certification, and a master's degree in a specified or related human services field. The role also requires familiarity with addiction treatment documentation and competence in applying diagnostic and medical-necessity criteria.

Requirements

• A minimum of five years of electronic medical records experience.
• HIPAA Privacy Certification.
• A master's degree in Social Work, Psychology, Counseling, or a related Human Services field.
• Ability to obtain appropriate clinical documentation from the electronic medical record to reflect services provided.
• Familiarity with addiction treatment service documentation.
• Understanding of current DSM diagnostic and ASAM Medical Necessity Criteria.
• Competence in making provisional mental health and chemical dependency diagnoses and level-of-care recommendations using available information.
• Understanding of mental health and chemical dependency inpatient, partial hospital, intensive outpatient (IOP), and outpatient modalities based on assessment and medical-necessity criteria.

Nice To Haves

• Licensed Clinical Drug and Alcohol Counselor (LCADC) credential.
• Knowledge of and background in managed care and insurance.
• At least five years of experience in substance use and/or mental health.
• Experience with all target populations.
• Direct experience performing benefits and/or utilization management in a managed care setting.

Responsibilities

• Oversee all aspects of the Medical Records and Custodian of Records functions, including staff supervision.
• Serve as the designated enterprise-wide Custodian of Records.
• Liaise with external parties, including payors and attorneys, seeking medical records or making inquiries.
• Maintain new and archived medical records and charts.
• Develop and implement enterprise-wide medical records processes, including disclosure accounting, payment processing and reconciliation, and segregation of records based on specified criteria.
• Create policies and procedures for medical records storage, retrieval, and destruction.
• Oversee and coordinate responses to third-party medical records requests.
• Compile information for payor audits.
• Oversee and reconcile medical records fee arrangements in accordance with state law and maintain a monthly report.
• Maintain storage logs and procedures for destruction of outdated records in accordance with company retention and destruction procedures.
• Develop medical records maintenance and destruction policies in consultation with the Chief Compliance Officer and/or In-House Counsel.
• Develop, compile, and analyze statistical data and prepare reports from medical record information.
• Determine appropriate release of medical records and prepare correspondence in response to requests in accordance with company policies and applicable laws.
• Ensure the medical records department and its processes comply with applicable laws and regulations, including HIPAA, 42 CFR Part 2, and state record-retention laws.
• Participate in internal meetings regarding medical records and patient information.
• Coordinate and integrate the Medical Records Department's work with other departments.
• Appear in court in response to subpoenas, court orders, and administrative orders concerning medical records.
• Ensure compliance with medical record maintenance standards and best-in-class standards for storage, disclosure, and destruction.
• Ensure medical record information in the company database is accurate and current.
• Conduct regularly scheduled Medical Records Desk Audits.
• Oversee the external medical records storage process.
• Attend company and department meetings as required and internal training as directed.
• Complete assigned external training courses and certifications as requested.
• Conduct oneself consistently with the company's mission, vision, and values.
• Maintain working knowledge of HIPAA, 42 CFR Part 2, OSHA, Risk Management, and Compliance regulations.
• Follow confidentiality and privacy protocols in accordance with company policies and applicable laws and regulations.
• Serve on the company's Internal Compliance and Risk Management Committee(s).

Benefits

• 18 days of paid time off.
• 401(k) with company match.
• Company-sponsored ongoing training and certification opportunities.
• Comprehensive benefits package including medical, dental, vision, short-term disability, long-term disability, and accident insurance.
• Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP).

What This Job Offers

• Job Type: Full-time
• Career Level: Director