Utilization Management Medical Records Coordinator
About The Position
The Utilization Management Medical Records Coordinator is responsible for all forms and aspects of medical record retrieval, including, but not limited to, claims data analysis, outreach data research, Request of Information (ROI) deployment, pend-record resolution, medical record audits, attestation capture, and report documentation. In addition, the Utilization Management Medical Records Coordinator serves as a knowledge resource for the team. They will leverage their knowledge to address issue escalations, research process enhancements, and resolve complex/problematic medical record retrieval issues.
Requirements
- High School or GED diploma required
- Eighteen (18) months of clinical and/or insurance experience, or related healthcare education or certification (i.e. STNA, MA, etc.) required
- Intermediate proficiency in the Microsoft Office Suite
- Verbal and written communication skills
- Ability to work independently and within a team environment
- Attention to detail
- Critical listening and thinking skills
- Time management skills
- Proper phone etiquette
- Data analysis
- Business analysis
- Project management
- Customer service orientation
- Brand ambassadorship
- Decision making/problem solving skills
- Takes initiative to research and resolve obstacles
- Must be able to self-direct work when given a goal/task
Nice To Haves
- Managed Care experience preferred
Responsibilities
- Coordinate and execute the request, retrieval, and pend resolution of medical records through various channels
- Provide personal information necessary to gain access to health network systems when needed
- Collaborate with health systems and provider offices to execute and document their process for release of information requests
- Enhance and update operational databases, and provide context by documenting commentary
- Initiate, support, and implement process improvements with all external and internal partners
- Utilize the office suite including, but not limited to MS Teams, Office, Excel, Outlook, and Word to facilitate record retrieval and execute mail merge
- Verify retrieved medical records’ accuracy
- Manage portal, and FTP-based data transfers to facilitate medical record retrieval
- Manage practice and health network relations to minimize provider abrasion
- Generate specific reports to drive and reflect the execution of risk adjustment programs
- Support and refine implementation of risk adjustment processes across all lines of business
- Review, research, and correct claims data to produce information optimized for chart retrieval
- Review and reconcile retrieval related invoices
- Meet production and quality standards for medical record processing cycle
- Support special projects
- Assist with team’s training and development
- Serve as knowledge resource for team
- Perform any other job related duties as requested.
Benefits
- bonus tied to company and individual performance
- substantial and comprehensive total rewards package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
