Medical Records Specialist

Description Full Time - Medical Records Specialist The Medical Records Specialist is responsible for managing and fulfilling medical records and documentation requests from payers, facilities, legal, and other internal departments, ensuring timely and accurate submission of the requested records. This role requires close coordination with facilities, internal departments, payers, and patients to verify, retrieve, and submit required information in compliance with organizational policies, HIPAA, and 42 CFR Part 2 regulations. The Medical Records Specialist also plays a key role in mitigating revenue loss by supporting claims resolution, handling denial-related documentation, and maintaining thorough records of all actions taken.

Essential Duties & Responsibilities:

Manage the intake, processing, and fulfillment of medical records and documentation requests from payers, clinics, and legal entities, ensuring timely and accurate submission. Review assigned claims that require medical record submission, working each item to resolution in accordance with organizational and payer-specific guidelines. Accurately document all actions taken, including claims worked and records submitted, in alignment with standard operating procedures. Retrieve and submit required documentation via mail, fax, or payer portals, adhering to individual payer submission requirements. Research and verify documentation requirements for each insurance company and ensure all requested information is included in submissions. Confirm the appropriate submission method (mail, fax, portal) for each request or appeal and ensure delivery to the correct destination. Proactively handle medical record requests related to claim denials to mitigate revenue loss. Review and respond to correspondence from payers, ensuring all inquiries are addressed promptly and thoroughly. Collaborate with RCM, legal, clinics, and other internal departments to coordinate timely and accurate documentation submission. Identify and communicate trends, barriers, or recurring issues to supervisors and management to support process improvement. Work collaboratively with the BayMark legal team regarding all privacy and compliance related matters and training. Obtain Releases of Information (ROI) from patients, or confirmation of 42 CFR Part 2 compliance from payers for SUD patients and HIPAA compliance confirmation for primary care patients. NSC - Medical Records Specialist Job Description Page 2 Document and retain all patient releases and 42 CFR Part 2 compliance confirmations from payers in patient medical records and/or internal tracking tools. Adhere to all BayMark policies and procedures concerning privacy, records maintenance, compliance and other related matters. Work collaboratively with facility-level staff and leadership as needed to fulfill the record requests and obtain patient ROI forms. Maintain all security passwords given to him/her. Maintain storage of all electronic data essential for functioning on the server. Participation in all required training. Performs other duties as assigned by supervisor .

Qualifications:

• Minimum of two (2) years of experience in accounts receivable, patient account services, or medical records management.
• Excellent verbal and written communication skills.
• Proven ability to think critically, solve problems effectively, and manage time and tasks with strong organizational skills.
• Strong interpersonal skills with the ability to collaborate and build effective working relationships across diverse teams, departments, and levels of leadership.
• The utmost integrity in the discreet and confidential handling of confidential information and materials.
• Understanding of the importance of patient confidentiality and complying with HIPAA and 42 CFR Part 2 regulations.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams, etc.).
• Successful completion of a criminal background check and drug screening.
• Satisfactory references from employers and/or professional peers.

Benefits:

Competitive salary Comprehensive benefits package including medical, dental, vision and 401(K) Generous paid time off accrual Excellent growth and development opportunities Satisfying and rewarding work striving to overcome the opioid epidemic Here is what you can expect from us: BayMark Health Services specializes in the treatment of opioid addiction. BayMark Health Services provides medication-assisted treatment services in a variety of modalities and settings through our divisions: BAART Community HealthCare, Health Care Resource Centers and MedMark Services, Inc. BayMark Health Services, also provides traditional primary health care services, as well as integrated primary care, in select locations. BayMark Health Services is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.