Medical Records Clerk Salary in USA

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!!We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only)Job Summary Reviews medical documentation to determine correct coding on submitted medical and behavioral health claims utilizing appropriate clinical staff resources as needed to assist in review. Update authorizations as necessary with appropriate codes.Education & Experience Required: • High school diploma or G.E.D. • 1+ years claims review experience • Medical terminology knowledge • 1+ years working with medical documentation Preferred: • Claim coding experience • Knowledge of Behavioral health claims review • Certified Processional Coder (CPC)Key Responsibilities Conducts medical documentation review to determine appropriateness of coding of service o Validates medical determinations through research of resources including regulatory manuals, computer files and documentation. o Assists in preparation of cases for program payment or medical director review as indicated. o Validates all appropriate data is supplied with program invoice. o Reviews Authorization data for process improvements o Ensures contract compliance for timelines regarding resolution of medical documentation review and updates o Communicates effectively with management and peers. o Consistently meets quotas for position o Identifies and reports any potential quality or fraud issues to management, Quality Management or Program Integrity as needed. o Provides support regarding clinical and coding questions. o Performs other duties as assigned. o Regular and reliable attendance is required.Competencies Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback. Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation. Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate. Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented. Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment. Technical Skills: Thorough knowledge of policies and procedures, Managed Care concepts and medical terminology. Proficient with claim and coding tools such as Find-a-Code, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Ability to meet or exceed production standards in compliance with contract.Working Conditions Working Conditions: o Favorable working conditions in a climate controlled office space; must be available to cover any work shift; works within an office environment with minimal travel required; level II IT security clearance. o Extensive computer work with prolonged sitting. o Security clearance as required by contract.Company Overview Taking Care of Our Nation's Heroes. It's Who We Are. It's What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve! Our job is to make sure that America's heroes get connected to health care in the community. At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.BenefitsWe're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes: Medical, Dental and Vision Coverage Generous paid time off 401(k) Retirement Savings Plan (with matching) Short-term and long-term disability, basic life, and accidental death and dismemberment insurance Tuition reimbursement Paid volunteer time *Annual base salary for Colorado, Hawaii and Washington State residents: $46,000 - $51,000 depending on experience*Equal Employment OpportunityTriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

The work we do matters!Hiring Agency:Supreme Court - Agency 5Location: Lincoln Job PostingHiring Rate:$16.016Classification Salary Range:$1.00 - $1,000.00Job Posting:JR2024-00005119 Records Clerk/Cashier - Lancaster County Court (Evergreen) (Open)Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed):Job Description:$3,000 hiring bonus to join the Judicial Branch! (Bonus prorated proportionally for part-time positions) The Judicial Branch is a state-funded Branch of Government that offers benefits to include medical/dental/vision, $20,000 free basic life insurance, state-matched 156% retirement plan, 13 paid holidays, earned paid vacation and sick leave, tuition reimbursement and more. The Lancaster County Court in Lincoln, NE is taking applications for a full-time Records Clerk/Cashier position performing responsible clerical work in a county court under the supervision of a clerk magistrate, a clerk of court, or a division manager. This is an entry level clerical position.Work involves responsibility for performing a variety of clerical functions in a service area such as criminal/traffic, civil/small claims, or probate, guardian conservator and adoption, including responding to routine inquiries, filing, data entry, processing and issuing documents, receipting of fees/fine and other payments, and other general office duties including routine bookkeeping. Will also serve as a courtroom clerk. Work is performed under supervision and is reviewed for accuracy.HIRING RATE (during probationary period): $33,312.60 AnnuallyMINIMUM PERMANENT RATE (after probationary period): $34,145.50 AnnuallyCLOSING DATE: Open Until FilledApply as soon as possible; applications will close when the position is filled. The Judicial Branch values our employees as well as a supportive environment that strives to promote diversity, equity, inclusion and belonging. We recruit, hire, train and promote in all job qualifications at all levels without regard to race, religion, sex, age, national origin, disability, marital status, sexual orientation or genetics. The Judicial Branch adheres to Veterans Preference Laws.MINIMUM QUALIFICATIONS: High school graduation or equivalent plus two years of experience in an office setting. Higher education may be substituted for work experience on a year for year basis.PREFERRED QUALIFICATIONS: The ability to speak Spanish is preferred but not required. At least one year of court/law office experience or experience in processing and/or accounting for cash payments.OTHER QUALIFICATIONS: Successful completion of "on the job training" in JUSTICE (the statewide computer system) will be required within six months of hire.KNOWLEDGE, SKILLS AND ABILITIES: Requirements include typing skills, computer and data entry skills; the ability to follow instructions, strong customer service skills and good phone manners. Some knowledge of standard bookkeeping/financial procedures and practices. Ability to establish and maintain effective working relationships with other court employees and the general public.External Candidates -Please visithttps://statejobs.nebraska.govto complete a State application.Internal Candidates -apply viaJobs Hub through Workday, here: https://www.myworkday.com/son/d/task/2998$42366.htmld#backheader=trueBenefitsWe offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.Check out all that the State of Nebraska has to offer! For more information on benefits currently offered to permanent teammates, please visit: https://statejobs.nebraska.gov/index.html#benefitsEqual Opportunity StatementThe State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.Current employees of the State of Nebraska should NOT apply on this external career. Instead go to Workday and access the Jobs Hub - Internal Apply app from your home landing page.

The work we do matters!Hiring Agency:Supreme Court - Agency 5Location: Omaha Job PostingHiring Rate:$16.016Classification Salary Range:$1.00 - $1,000.00Job Posting:JR2024-00005347 Records Clerk/Cashier (Open)Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed):Job Description:$3,000 hiring bonus to join the Judicial Branch! (Bonus prorated proportionally for part-time positions) The Judicial Branch is a state-funded Branch of Government that offers benefits to include medical/dental/vision, $20,000 free basic life insurance, state-matched 156% retirement plan, 13 paid holidays, earned paid vacation and sick leave, tuition reimbursement and more. The Douglas County Court in Omaha, NE is taking applications for a full time Records Clerk/Cashier positions in our Criminal Traffic Division. This is an entry level clerical position. Records Clerks in all divisions will assist people attending court by directing them to appropriate windows for completing their respective actions. Some court attendance may be required. Data entry and attention to detail is paramount. Additional details of the positions are outlined below:Work involves performing various clerical functions, including receiving fees/fine and other payments, responding to routine inquiries, filing, data entry, and other general office duties, including routine bookkeeping. Additional responsibilities may include being assigned to a primary cash handling position within the Criminal Traffic Division. Work is performed under the supervision of the Division Manager of the Criminal Traffic Division and is reviewed for accuracy. Previous cash handling experience is preferred. The Criminal Traffic Division is a separate and distinct Division within Douglas County Court and has the highest volume of records. HIRING RATE (during probationary period): $33,312.60 AnnuallyMINIMUM PERMANENT RATE (after probationary period): $34,145.50 AnnuallyCLOSING DATE: Open Until FilledApply as soon as possible; applications will close when the position is filled. The Judicial Branch values our employees as well as a supportive environment that strives to promote diversity, equity, inclusion and belonging. We recruit, hire, train and promote in all job qualifications at all levels without regard to race, religion, sex, age, national origin, disability, marital status, sexual orientation or genetics. The Judicial Branch adheres to Veterans Preference Laws.Requirements / Qualifications: Minimum Qualifications: High school graduation or equivalent plus two years of experience in an office setting. Higher education may be substituted for work experience on a year for year basis.Preferred Qualifications: The ability to speak Spanish is preferred but not required. At least one year of court/law office experience or experience in processing and/or accounting for cash payments.Other: Successful completion of "on the job training" in JUSTICE (the statewide computer system) will be required within six months of hire.KNOWLEDGE, SKILLS AND ABILITIES: Requirements include typing skills, computer and data entry skills; the ability to follow instructions, strong customer service skills and good phone manners. Some knowledge of standard bookkeeping/financial procedures and practices. Ability to establish and maintain effective working relationships with other court employees and the general public.External Candidates -Please visithttps://statejobs.nebraska.govto complete a State application.Internal Candidates -apply viaJobs Hub through Workday, here: https://www.myworkday.com/son/d/task/2998$42366.htmld#backheader=trueBenefitsWe offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.Check out all that the State of Nebraska has to offer! For more information on benefits currently offered to permanent teammates, please visit: https://statejobs.nebraska.gov/index.html#benefitsEqual Opportunity StatementThe State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.Current employees of the State of Nebraska should NOT apply on this external career. Instead go to Workday and access the Jobs Hub - Internal Apply app from your home landing page.

The work we do matters!Hiring Agency:Supreme Court - Agency 5Location: Omaha Job PostingHiring Rate:$16.016Classification Salary Range:$1.00 - $1,000.00Job Posting:JR2024-00005196 Records Clerk (Open)Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed):Job Description:The Judicial Branch is a state-funded Branch of Government that offers benefits to include medical/dental/vision, $20,000 free basic life insurance, state-matched 156% retirement plan, 13 paid holidays, earned paid vacation and sick leave, tuition reimbursement and more. The Douglas County Court is taking applications for a full time Records Clerk/Cashier position in our Civil Division. This is an entry level clerical position. One of the major and significant job duties is data entry from various legal documents. In addition, work involves a variety of general office duties which include responding to routine inquiries, typing and computer functions under the supervision of the Division Manager of the Civil Division. The Civil Division is a separate and distinct Division within Douglas County Court, outside of Criminal/Traffic and Probate, working with Small Claims and other Civil court actions. Supplementary duties include assisting people attending court and helping them locate appropriate window to complete their respective actions. Data entry and attention to detail is paramount.Requirements / Qualifications: Minimum Qualifications: High school graduation or equivalent plus two years of experience in an office setting. Higher education may be substituted for work experience on a year for year basis.Preferred Qualifications: The ability to speak Spanish is preferred but not required. At least one year of court/law office experience or experience in processing and/or accounting for cash payments.Other: Successful completion of "on the job training" in JUSTICE (the statewide computer system) will be required within six months of hire.KNOWLEDGE, SKILLS AND ABILITIES: Requirements include typing skills, computer and data entry skills; the ability to follow instructions, strong customer service skills and good phone manners. Some knowledge of standard bookkeeping/financial procedures and practices. Ability to establish and maintain effective working relationships with other court employees and the general public.$3,000 hiring bonus to join the Judicial Branch! (Bonus prorated proportionally for part-time positions)BenefitsWe offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.Check out all that the State of Nebraska has to offer! For more information on benefits currently offered to permanent teammates, please visit: https://statejobs.nebraska.gov/index.html#benefitsEqual Opportunity StatementThe State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.Current employees of the State of Nebraska should NOT apply on this external career. Instead go to Workday and access the Jobs Hub - Internal Apply app from your home landing page.

Job Functions, Duties, Responsibilities and Position Qualifications:Multi-tasking is your middle name. You've got great typing skills, a passion for solving problems, and a way of explaining things that helps people feel valued. You're also looking for great benefits, the support of an all-star team, and an opportunity to grow your career.Join our front line of #HealthcareHeroes! Our mission is to advance the health and wellbeing of our communities as a leader in clinical laboratory solutions. Quality is in our DNA -- is it in yours?This opportunity is full-time during first shift.In this role, you will:Responsible for office procedures such as answering and triaging incoming calls, data entry, maintaining documentation for the department, faxing of reportsRecognize when corrective action is needed and implement effective solutionsWork in an office environmentChampion safety, compliance, and quality controlAll you need is:High School Diploma or equivalent1 year of experience working in a call center or in the laboratoryExceptional communication skillsTop notch typing proficiency (at least 35wpm), including 10-keyAbility to thrive in a fast-paced environmentBonus points if you've got:Associate's Degree or Medical Assistant trainingData entry experience in a production environmentWe'll give you:Appreciation for your workA feeling of satisfaction that you've helped peopleOpportunity to grow in your professionFree lab services for you and your dependentsWork-life balance, including Paid Time Off and Paid HolidaysCompetitive benefits including medical, dental, and vision insuranceHelp saving for retirement, with a 401(k) plus a company matchA sense of belonging - we're a community!We also want you to know:This role will have routine access to Protected Health Information (PHI). Employees will be trained on reasonable safeguards and are expected to maintain strict confidentiality, as well as abide by all applicable privacy and security standards. Employees are expected only to access PHI when it is required to fulfill job duties.Scheduled Weekly Hours:40Work Shift:Job Category:AdministrationCompany:Clinical Pathology Laboratories, Inc.Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Medical Records ClerkBC Forward is currently seeking a highly motivated "Medical Records Clerk" for an opportunity in Miami, FL 33125Position Title: Medical Records ClerkLocation: Miami, FL 33125 Anticipated Start Date: Tentative 05/06/2024Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date. Expected Duration: 3MonthsJob Type: Full Time 40 Hours Contract, OnsitePay Range: $15.5/Hr an hour on W2Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.). Job Description:100% in officeMonday - Friday from 8:00 to 5:00Responsible for maintaining patient files, responds to requests for medical records and performs clerical activities in support of the medical records department. Primary duties may include, but are not limited to: Protect the security and integrity of medical records to ensure that patient confidentiality is maintained in compliance with company policies and federal, state and local regulations. Maintains patient files and retrieves files for scheduled appointments; Responds to requests for medical records; processes letters and report.Requires a high school diploma/GED; 1 year related experience; or any combination of education and experience, which would provide an equivalent background.Performs Clerical duties such as physician calls, and follow-up as directed with letters to different agencies and or providers' offices.RequiredBilingual SpanishGeneral Computer Knowledge (Microsoft Office, etc.)Previous experience in Healthcare environment and medical terminologyProficiency in electronic health record softwareBenefits: BC Forward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k. About BC Forward: Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally. ideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process. This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.Interested candidates please send resume in Word format Please reference job code 220923 when responding to this ad.Get job alerts by email.Sign up now!Join Our Talent Network!Job SnapshotEmployee TypeContractorLocationMiami, FL (Onsite)Job TypeAdmin - ClericalExperienceNot SpecifiedDate Posted04/18/2024

Medical Records ClerkBCforward is currently seeking a highly motivated "Medical Records Clerk" for an opportunity in North Miami Beach FL Position Title: Medical Records Clerk Location: North Miami Beach FL Job Posting Start Date: 05/06/2024 Monday - Friday: 8:00 to 5:00 (Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date._ Expected Duration:3 months Job Type: 40 hours work week & Contract for 3 months Pay Rate: $15.50 /hr Description: Medical Records Clerk Position Description: Responsible for maintaining patient files, responds to requests for medical records and performs clerical activities in support of the medical records department. Primary duties may include, but are not limited to: Protect the security and integrity of medical records to ensure that patient confidentiality is maintained in compliance with company policies and federal, state and local regulations. Maintains patient files and retrieves files for scheduled appointments; Responds to requests for medical records; processes letters and report. . Requires a high school diploma/GED; 1 year related experience; or any combination of education and experience, which would provide an equivalent background. Responsibilities Responsible for maintaining patient files, responds to requests for medical records and performs clerical activities in support of the medical records department. Primary duties may include, but are not limited to: Protect the security and integrity of medical records to ensure that patient confidentiality is maintained in compliance with company policies and federal, state and local regulations. Maintains patient files and retrieves files for scheduled appointments; Responds to requests for medical records; processes letters and report. . Requires a high school diploma/GED; 1 year related experience; or any combination of education and experience, which would provide an equivalent background. Required skill sets, experiences, or methodologies (technical or otherwise) or put N/A Bilingual - Spanish is required Mandatory Skills:Previous experience in healthcare environment (clinic) and medical terminologyProficiency in electronic health record softwareWhat is your anticipated work schedule for this job posting? 100% onsite 30 minute interviews will be onsite Additional Job Description Details Performs other clerical duties such as physician calls, follow up as directed with letters to different agencies and or provides offices.Get job alerts by email.Sign up now!Join Our Talent Network!Salary DetailsThis salary was provided in the Job Posting.$15-$15.50Hourly SalaryJob SnapshotEmployee TypeContractorLocationNorth Miami Beach, FL (Onsite)Job TypeAdmin - ClericalExperienceNot SpecifiedDate Posted04/18/2024

Lutheran Living is looking for a full-time Medical Records Clerk to provide loving and quality care and service to our residents living in our independent, assisted and memory care community. Lutheran Living was recognized as a 2023 recipient of the Bronze -- Commitment to Quality Award by AHCA/NCAL for our commitment to improving the lives of seniors and individuals with disabilities with quality care and services. This position is an integral role that is the heartbeat of this community. We know that our Team's commitment and relationship with our residents is critical in supporting their quality of life and satisfaction. The ideal candidate thrives in a team-centric environment, excels in innovation and accountability, and has a love for serving seniors. Lutheran Living is committed to the core values of hospitality, stewardship, integrity, respect, and humor. These values, in addition to the significance and impact on the service we provide, determine our priorities, inform our decisions, and represent stability to those we serve. Hospitality Creating a culture that promotes teamwork and collaboration Listening attentively and courteously Honoring the uniqueness and worth of each individual Extending a warm and welcoming atmosphere Embracing new ideas, being flexible, and open to change Stewardship Taking initiative and anticipating the needs of others Contributing our time and talents responsibly Using material, energy, and monetary resources as efficiently as possible Being predictive in problem solving Integrity Creating a daily practice of doing the right things. Being accountable for and being engaged in the commitments we have made Building trustworthy relationships with others Telling the truth Striving for quality and excellence in all we do Respect Cherishing and promoting the worth of all human life Valuing the dignity of all work Promoting participation of team members in decision making Responding timely in communications Humor Embracing creativity and new ideas Learning and growing from our mistakes Encouraging joy and laughter Taking the work, but not ourselves too seriously Having fun at work! Job Types: Full-time, Day Shift Benefits: Same Day Pay Career Ladders with Tuition Reimbursement Generous/Flexible PTO plan Medical/Dental/Vision Insurance Generous PTO Package Employee Assistance Program Weekly schedule: Weekends and holidays as needed Ability to commute/relocate: Muscatine, IA: Reliably commute or planning to relocate before starting work (Required)

Description Uses an electronic medical record to create, maintain, and retrieve patient medical records. Obtain outside records, including converting records and images into internal systems for accessibility. Update current records based on information requested for upcoming appointments. Completes patient disability forms, including FMLA, OTJ, work release/status, and individual insurance forms. Assign information received from outside facilities into correct patient charts Provide patient records to outside parties and ensuring that all security measures are met to meet HIPAA guidelines. Reviews medical records for completeness, ensuring items are correctly filed into the electronic chart. Electronically file appropriate correspondence, reports, etc. in patient charts. Distribution of mail, open, sort and deliver. Other duties as assigned.

The rewards at Healogics are immense, starting with the important work we do to change patients' lives. We also understand that meaningful work is hard work, and we are committed to supporting and compensating our employees for the tremendous service they provide.Think you are a great fit? Learn more about this role here:Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. With an aging society, obesity and diabetes on the rise, and an uptick in surgical procedures, the number of patients with non-healing wounds that would benefit from expert care is dramatically increasing. As a result, the company is working to provide our differentiated, quality outcomes to as many patients that would benefit through our out-patient clinic partnerships.The Medical Records Analyst & Educator is a member of HWCS' Healogics Documentation Team who works closely with outside vendors and / or customers as well as internal HWCS staff and employees of other Healogics entities. The duties and responsibilities of the Medical Records Analyst & Educator include analysis of medical records to support daily claims analysis and "scrubbing" of claims against relevant payor criteria for coverage. This includes Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) associated with Medicare and its Medicare Administrative Contractors (MACs) as well as coverage guidance provided by other governmental payors and private payor entities. The Medical Records Analyst & Educator is responsible for collection, validation, and analysis of patient information applicable to specific DME or other supply orders and referencing internal and external guidance material which identifies documentation necessary from the medical record for "scrubbing" of the claim associated with the order. The Medical Records Analyst & Educator is also responsible for reconciliation of "missing documentation" reports for claims under review and education of clinical staff and patient navigators with respect to why said information necessary for the review of a particular claim. From time to time, the Medical Records Analyst & Educator also will be required to compile data and otherwise assist in reporting and auditing related to activities of the Healogics Documentation Team.Due to the requirement to routinely access medical records, this position requires a familiarity and compliance with the Health Insurance Portability and Accountability Act ("HIPAA") as well as similar state laws. This position requires a general familiarity with electronic medical record ("EMR") systems. Healogics has its own EMR system - i-heal. Training specific as to the use of this system will be provided.This position requires familiarity a variety of coverage determination publications from governmental and private payors and maintaining familiarity as updated materials on such coverage determinations are published. In instances where guidance material is unclear or conflicting, the Medical Records Analyst & Educator must be able to interpret available material and provide a written opinion as to coverage based on facts related to a specific situation. A basic understanding of medical terminology and working familiarity with Medicare LCDs and NCDs is required. Training as to updated coverage determination materials and new payors with which the Medical Records Analyst & Educator are expected to be familiar will be provided.The Medical Records Analyst & Educator will understand and fully support the mission, vision, and value statements of HWCS and the Healogics family of companies. The Medical Records Analyst & Educator contributes directly to the Healogics Key Result of "Grow the Business" by assisting in the process of efficient claims management and indirectly to the Healogics Key Result of "Exceptional Patient Experience" by ensuring that patient claims are handled promptly and accurately.All HWCS employees must perform their job responsibilities according to all company policies, as well as hospital policies, policies of accrediting organizations, federal and state regulations, and guidelines of the Centers for Medicare and Medicaid Services (CMS), as applicable.Essential Functions/ResponsibilitiesReview order packets for DME or supplies as compiled by the Medical Records Processor. Confirm relevant payor for the order. Confirm documentation provided is complete based on the requirements of the payor and DME / supply ordered. Return incomplete order packets to the Medical Records Processor and identify what documentation is missing. As necessary, work with Medical Records Processor to contact and educate accounts regarding missing documentation. The Medical Records Analyst & Educator may be required to educate center-based staff when data required by a payor to process a DME / supply order is missing from documentation, i.e., progress notes or wound assessments missing data such as duration of need, quantity used per day, total quantity used, etc. The Medical Records Processor should engage in continued contact to ensure supplemental data or documentation is received once education has been provided. Engage in formal and informal education to wound care center-based staff, including patient navigators, case manager, clinical nurse managers, and providers as to documentation and data necessary for review of DME / supply orders based on the coverage requirements of specific payors. Analyze order packets based on the identified payor and their associated coverage determination guidance. Classify order packets as (i) clearly meets payor guidance as to medical necessity, (ii) based on reviewer's opinion, meets payor guidance as to medical necessity (with written opinion), (iii) clearly does not meet payor guidance as to medical necessity, or (iv) based on reviewer's opinion, does not meet payor guidance as to medical necessity. For determinations in categories (ii) and (iv), meet with DME Documentation & Education Manager and / or other individuals within Healogics who have expertise as to payor coverage determinations and confer as to final position as to medical necessity based on the specific payor and DME / supply ordered. Ensure proper documentation of consensus opinion. Upload and maintain collected analysis and determination documents in HWCS' Documentation Repository System. Provide routine follow-up to wound care center-based staff to advise of metrics related to initial completeness of documentation for order packets received as well as validation rate for medical necessity requirements. Assist with departmental audits as well as vendor or customer audits. Follow all confidentiality and security requirements as to medical records. Follow all documentation and tracking requirements related to records requests to allow for data analysis of program efficacy and efficiency. Complete administrative duties including answering phones, taking messages, responding to emails, communicating information back to vendors / customers, maintaining necessary logs, and collaborating with fellow team members. Participate in improving quality throughout the company and the Healogics organization. Perform other duties as required.Required Education, Experience And CredentialsAssociates degree from an accredited university or college in business, accounting, finance, healthcare administration or related field or equivalent experienceMinimum of two (2) to four (4) years related experience in health care finance and/or revenue cycle in hospital, physician office or., other related setting.Required Knowledge, Skills And AbilitiesWorking knowledge of DME coding, billing, payor requirements, and denial management. Must have a working knowledge of the Medicare and MAC codes, rules, regulations, pronouncements and applicable Fiscal Intermediary polices (e.g. Local Coverage Determinations). Familiarity with medical terminology. Proficient in Microsoft Suite (Excel, Word, Outlook). Keen attention to detail with the ability to work independently and maintain confidentiality. Ability to collaborate and demonstrate leadership skills in a team environment. Strong interpersonal, written and verbal communication skills with a focus on customer service. Organization, prioritization and time management skills. Working knowledge of systems/applications with indication of those preferred. Demonstrated ability to exhibit integrity and commitment to professional ethics. Budget and long-term planning skills.The salary for this position generally ranges between $44,800.00 - $66,300.00 AnnuallyThis range is an estimate, based on potential employee qualifications: education, experience, geography as well as operational needs and other considerations permitted by law.If you are a current employee, to submit a job application, you need to apply as an internal candidate in Workday via the "Jobs Hub".