Contract Specialist Jobs

About The Position

Requirements

• Strong knowledge of HIPAA and confidentiality regulations.
• Familiarity with AHCA, DCF, and CARF standards.
• Ability to manage high volumes of requests while maintaining accuracy and timeliness.
• Excellent attention to detail and organizational skills.
• Proficiency in EHR platforms (e.g., BestNotes) and Microsoft Office Suite.
• Strong written and verbal communication skills.
• Professional discretion and ability to maintain confidentiality in all matters.
• Understands and maintains professional boundaries.
• Demonstrates an understanding of rules/limits of patient confidentiality and maintains appropriate levels of client confidentiality/privacy.
• Demonstrates consideration of and respect for values and cultural beliefs.
• High School Diploma or GED required.
• Minimum of 2 years in medical records, health information management within a behavioral health or healthcare setting.
• Must have 1 to 2 years experience in Behavioral Health in Medical Records
• Experience working with UR Specialist and Insurance Appeals.
• Medical Records Management/Release of Information (ROI)/EMR/HER/Record Requests.
• Valid Florida Driver’s License.
• Current CPR and First Aid Certification, or willingness to complete within the first 30 days of employment.
• Clearance of TB test.
• AHCA Level II Background

Nice To Haves

• Associate’s or bachelor’s degree in health information management, Healthcare Administration, or related field preferred.
• Experience with payer appeals and electronic health record systems preferred.

Responsibilities

• Gather patient demographic and personal information.
• Issue medical files to persons and agencies according to laws and regulations.
• Ensure patient charts, paperwork, and reports are completed in an accurate and timely manner.
• Make sure all medical records are protected and kept confidential.
• Serve as the official custodian of client health records, ensuring proper maintenance, security, and release of information in compliance with HIPAA, AHCA, DCF, and CARF standards.
• Receive, log, and process all requests for clinical documentation, including those from clients, family members, referents, insurance payers, attorneys, auditors, and internal departments.
• Verify appropriate authorization for release of information (ROI) prior to disclosure and ensure all releases are documented in the client record.
• Pull, compile, and redact clinical documentation as needed, ensuring accuracy, completeness, and adherence to confidentiality policies.
• Track and respond to record requests within required timeframes, maintaining detailed logs of all outgoing disclosures.
• Coordinate with clinical and administrative staff to retrieve or clarify missing or incomplete documentation.
• Maintain and update record retention, storage, and destruction logs per policy and legal standards.
• Work closely with Utilization Review staff to assemble documentation for written insurance appeals related to denials, level-of-care determinations, or medical necessity disputes.
• Submit and track written appeals, maintaining a centralized appeals log that includes dates, payer, level of care, reason for denial, and final determination.
• Ensure all appeal packets are complete, professionally formatted, and compliant with payer and regulatory requirements.
• Maintain strict confidentiality of all health information and ensure all recordkeeping activities meet federal and state privacy regulations.
• Stay informed of current AHCA, DCF, CARF, and payer documentation standards.
• Report any suspected privacy or data breaches immediately to the Compliance Officer.