Medical Records & Prior Authorization Supervisor

Rural Health Group, Inc.•Roanoke Rapids, NC

45d

About The Position

In order to qualify for this position, you must genuinely like and care about people, be kind and compassionate as well as supremely professional, organized and courteous to both patients and staff. You must have excellent skills as a communicator and as a collaborator, and be willing to adapt to circumstances as they change. The individual we seek needs to have thorough knowledge of the complexities involved in a Family Practice office. Supervisory experience is required The Medical Records and Prior Authorization Supervisor oversees daily operations related to health information management, medical records requests, and insurance prior authorizations. This role ensures compliance with HIPAA, UDS reporting requirements, payer guidelines, and FQHC standards. The supervisor leads a team responsible for processing authorizations, managing record release, managing incoming records, supporting providers, and maintaining the integrity of patient data within the EHR.

Requirements

Associate/Bachelor's Degree in Business, Health Administration is preferred
Supervisory experience is required
Excellent verbal and written communication skills
High school diploma or GED
Must have basic knowledge of Medical Records and/or Referral's operations
Ability to multi-task and work efficiently in a potentially fast-paced environment
Possess the tact and attitude necessary to deal effectively with patients, providers, and employees
Willing to travel to other Rural Health Group, Inc. sites to assist other facilities in areas of assigned responsibilities
Ability to apply common sense understanding when carrying out detailed written or oral instructions
Ability to establish and maintain positive, effective, professional relationships with patients, providers, coworkers, and superiors
Possess knowledge of modern office equipment, Microsoft Office software programs, and electronic health record
Must be able to quickly learn to use eClinicalWorks electronic health record system
Must be able to stand for long periods of time
EOE. Federal and State Criminal Background Checks and Drug Screen required for all positions. Influenza vaccines is a condition of employment.
E-Verify Notice: After accepting employment, new hires are required to complete an I-9 form and present documentation of their identity and eligibility to work in the United States.

Nice To Haves

Associate/Bachelor's Degree in Business, Health Administration is preferred

Responsibilities

Supervise, train, and evaluate medical records and prior authorization staff.
Develop workflows and performance standards to maximize efficiency and accuracy.
Coordinate with clinical, billing, and referral departments to resolve barriers in care authorizations or record retrieval Monitory daily workloads, turnaround times, and quality metrics.
Oversee processing of prior authorization requests for medications, imaging, procedures, and specialty care.
Maintain updated payer requirements and communicate change to staff.
Ensure timely fulfillment of medical records requests in accordance with HIPAA, state laws, and organizational policy.
Ensure accuracy, security, and integrity of patient health information in the EHR.
Manage release of information, chart corrections, scanning, and data integrity tasks.
Support compliance with UDS, PCMH, and other reporting requirements.
Maintain strict compliance with HIPAA, CMS, HRSA, and payer regulations.
Participate in internal audits and quality improvement initiatives.
Develop and update policies and procedures related to health medical records and prior authorizations.
Teambuilding
Must be able to adhere to the core competencies of the organization, which include: Good Judgment Communication/Customer Service/Teamwork Passion Honesty Responsibility
Job-Specific Skill Set Access to Care Insurance Verification Collection of Co-pays and/or Balances Complete Registration Presence and Compliance
All duties and responsibilities will be performed in a manner consistent with Rural Health Group's mission, values, guiding principles, and standards.