We are seeking a dedicated and detail-oriented Document Review Specialist to join our Medical Records and Support Department. This pivotal role is responsible for supporting key functions across the department, ensuring the accuracy, integrity, and compliance of medical records throughout the health system. You will be instrumental in facilitating medical record audits, managing communication with payors, overseeing the continuation of care process, and addressing legal requests in accordance with regulatory and organizational standards.
Key Responsibilities:
Medical Record Audits: Conduct and coordinate comprehensive audits of medical records to ensure compliance with regulatory requirements, The Joint Commission standards, and internal policies. Prepare detailed reports for Medical Staff, Nursing Leadership, and Medical Record Committee meetings.
Payor Communication: Support communication efforts with payors by ensuring timely and accurate documentation for claims processing, inquiries, and follow-up. Assist in resolving discrepancies and ensuring appropriate documentation for reimbursement.
Continuation of Care: Facilitate the continuation of care process by ensuring that patient records are complete, accurate, and shared in a timely manner across care teams and between facilities to promote seamless transitions of care.
Legal Requests: Oversee and manage the process for legal requests related to medical records, including those related to subpoenas, patient rights, and compliance with legal and regulatory standards. Ensure all requests are processed efficiently and accurately.
Additional Duties: Assist with amendment requests, wrongful disclosures, and ensure the accurate tracking and documentation of Deceased Patient Data forms. Support investigations into documentation omissions and ensure proper follow-up. Collaborate with other departments to maintain effective communication and data exchange.
This position is integral to maintaining the flow of accurate and compliant medical records across the organization. You will support the department manager in ensuring that all medical record processes align with legal, regulatory, and operational standards, playing a key role in the overall efficiency of the health system.
Ideal candidates will have strong organizational skills, an eye for detail, and the ability to manage multiple responsibilities simultaneously in a fast-paced healthcare environment. If you are a proactive problem-solver with a commitment to high standards in medical record management, we encourage you to apply.
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