Medical Records and Contracting Clerk

Northshore Health Centers, Inc; Chesterton (IN); On-site; USD 40,000 - 56,000; Full time

Job summary

NorthShore Health Centers, Inc is seeking a Medical Records and Contracting Clerk to ensure the integrity of patient records and timely processing of credentialing contracts. The role requires handling confidential data under HIPAA, scanning documents into EMR, and coordinating CAQH/Availity updates.

The position supports on-site operations, maintains data accuracy, and collaborates with the Medical Records Manager to keep supplies and processes compliant with regulatory standards.

Qualifications

• HS diploma or equivalent required; detailed records knowledge preferred.
• Experience with healthcare data and credentialing processes.
• Familiarity with HIPAA and confidentiality standards.
• Ability to manage multiple tasks and deadlines.

Responsibilities

• Process medical records requests and release of information securely.
• Scan and file documents into electronic medical records within 24 hours.
• Maintain confidentiality per HIPAA and policy guidelines.
• Assist with provider initial and re-credentialing applications.
• Update payer directories and use Availity/CAQH portals.

Skills

Analytical thinking

Excellent interpersonal skills

Customer service orientation

Time management

Attention to detail

Education

High School Diploma or equivalent

Bachelor’s Degree in Business, Finance, or Healthcare related studies (preferred)

Tools

Microsoft Office Suite

Availity portal

CAQH

Job description

Summary/ObjectiveThe Medical Records and Contracting Clerk is responsible for maintaining the integrity of all patient medical records, which includes prompt scanning/filing/handling/processing of all patient related documents and patient records, while maintaining patient confidentiality according to HIPAA guidelines, and NorthShore’s Information Security Policies. Additionally the Medical Records and Contracting Clerk is responsible for timely processing and completion of initial and re-credentialing insurance contracts for all NorthShore providers and locations.Essential FunctionsEnsures that all chart requests for transfer of records are completed in a timely manner with the appropriate release of information documentation.Processes all medical records request by patients/staff/third parties by copying medical records for release of information while ensuring the safety and confidentiality of all records.Scans documentation, laboratory, radiology reports, etc. into each patient’s electronic chart within 24 hours of receipt of each document.Ensures that all faxes are removed from the fax machine and processed in a timely manner, then placed in a secure area or in the shred container in order to maintain patient confidentiality.Reports to Medical Records Manager when supplies are low in the department, to help ensure an appropriate level of supplies and other materials are maintained at all times.Maintains confidentiality of all current and former patient medical records in accordance with NorthShore’s Information Security policies, HIPAA confidentiality requirements, and any/all other confidentiality regulations of all other governing regulatory agencies.Ensures that records are sent in a timely manner, as needed, during scheduled rotating on-call shift.Complete provider initial and re-credentialing applications, provider demographic update forms, and letters for Medicare, Medicaid, managed care plans, and commercial insurances.Maintain and remain in compliance with payer and product directory updates monthly and quarterly through portals such as Availity, LexisNexis, Better Doctor, and other validation tools.Utilize and navigate Medicaid, NPPES, CAQH and additional sites/portals for providers and NorthShore locations as they are needed.Construct new provider CAQH profiles, update current CAQH applications, and attest the CAQH profiles quarterly for all providers.Communicate with the appropriate NorthShore staff on the status of insurance contracts as needed.Attends mandatory staff meetings and department meetings as required.Performs other duties as identified or assigned.*These essential functions are a summary of the primary duties and responsibilities of the position, and are not intended to be a comprehensive listing of all duties and responsibilities. The position will include other duties as assigned, and duties are subject to change at management's discretion.CompetenciesPlanning and strategic foresightResponsible Decision MakingIntegrity and accountabilityInnovation and creativityAdaptive and flexibleLeadership, teamwork, and conflict resolutionProfessionalism and work ethicEmpathyWork EnvironmentWork is performed in an office environment. Involves frequent personal and telephone contact with patients, physicians, and other healthcare personnel. Work may be stressful at times. Interaction with others is constant and interruptive.TravelTravel within Northshore locations will be rare for this position. Travel outside of Northshore locations will be rare for this position.Summary/ObjectiveThe Medical Records and Contracting Clerk is responsible for maintaining the integrity of all patient medical records, which includes prompt scanning/filing/handling/processing of all patient related documents and patient records, while maintaining patient confidentiality according to HIPAA guidelines, and NorthShore’s Information Security Policies. Additionally the Medical Records and Contracting Clerk is responsible for timely processing and completion of initial and re-credentialing insurance contracts for all NorthShore providers and locations.Essential FunctionsEnsures that all chart requests for transfer of records are completed in a timely manner with the appropriate release of information documentation.Processes all medical records request by patients/staff/third parties by copying medical records for release of information while ensuring the safety and confidentiality of all records.Scans documentation, laboratory, radiology reports, etc. into each patient’s electronic chart within 24 hours of receipt of each document.Ensures that all faxes are removed from the fax machine and processed in a timely manner, then placed in a secure area or in the shred container in order to maintain patient confidentiality.Reports to Medical Records Manager when supplies are low in the department, to help ensure an appropriate level of supplies and other materials are maintained at all times.Maintains confidentiality of all current and former patient medical records in accordance with NorthShore’s Information Security policies, HIPAA confidentiality requirements, and any/all other confidentiality regulations of all other governing regulatory agencies.Ensures that records are sent in a timely manner, as needed, during scheduled rotating on-call shift.Complete provider initial and re-credentialing applications, provider demographic update forms, and letters for Medicare, Medicaid, managed care plans, and commercial insurances.Maintain and remain in compliance with payer and product directory updates monthly and quarterly through portals such as Availity, LexisNexis, Better Doctor, and other validation tools.Utilize and navigate Medicaid, NPPES, CAQH and additional sites/portals for providers and NorthShore locations as they are needed.Construct new provider CAQH profiles, update current CAQH applications, and attest the CAQH profiles quarterly for all providers.Communicate with the appropriate NorthShore staff on the status of insurance contracts as needed.Attends mandatory staff meetings and department meetings as required.Performs other duties as identified or assigned.*These essential functions are a summary of the primary duties and responsibilities of the position, and are not intended to be a comprehensive listing of all duties and responsibilities. The position will include other duties as assigned, and duties are subject to change at management's discretion.CompetenciesPlanning and strategic foresightResponsible Decision MakingIntegrity and accountabilityInnovation and creativityAdaptive and flexibleLeadership, teamwork, and conflict resolutionProfessionalism and work ethicEmpathyWork EnvironmentWork is performed in an office environment. Involves frequent personal and telephone contact with patients, physicians, and other healthcare personnel. Work may be stressful at times. Interaction with others is constant and interruptive.TravelTravel within Northshore locations will be rare for this position. Travel outside of Northshore locations will be rare for this position.Required Role QualificationsHigh School Diploma, Transcripts, or EquivalentPreferred Role QualificationsBachelor’s Degree in Business, Finance, or Healthcare related studiesTwo years of experience working within a healthcare setting.Required SkillsAbility to analyze situations and solve problems at strategic and tactical levelsExcellent interpersonal and customer service skillsAbility to comprehend, interpret, and apply the appropriate sections of applicable laws, guidelines, regulations, ordinances, and policiesAbility to acquire a thorough understanding of the organization's hierarchy, jobs, qualifications, compensation practices, and the administrative practices related to those factorsPracticed at organization and planningEmploy Critical thinking and problem solvingMaintains composure and operates with emotional intelligenceEthical reasoning and decision-makingStrong attention to detailReceptive and responsive to feedbackExcellent verbal and written communication skillsTime management, prioritization, and sense of urgencyProficient with Microsoft Office Suite or related software