Medical Records Specialist

Therapy and Beyond - ABA Therapy; Flower Mound (TX); On-site; USD 30,000 - 39,000; Full time

Job summary

Therapy & Beyond is seeking a Medical Records Specialist in Flower Mound, TX to manage ROI workflow, ensure HIPAA compliance, and support data integrity across EHR systems, safeguarding privacy and accurate billing.

The role serves as a bridge between clinics, insurance payers, and third-party requestors, ensuring information exchange is seamless and compliant while supporting the organization’s financial health.

Qualifications

• HS diploma required; degree preferred.
• 2 years medical billing/RCM experience preferred.
• Strong knowledge of medical billing, coding, and EMR systems.
• Excellent organizational and communication skills.

Responsibilities

• ROI workflow management: oversee ROI requests end-to-end.
• HIPAA, audit readiness & data privacy: maintain PHI security and compliance.
• Strategic payer follow-up: track remits and resolve issues with payers.
• Cross-functional collaboration: coordinate with clinics, billing, and admin teams.
• Queue management: prioritize tasks within revenue cycle operations.
• Revenue lifecycle management: assist with claim submission, adjudication, and posting.
• Quality control: audit claims for correct modifiers and data points before transmission.

Skills

EMR systems

Office software

Organizational skills

Interpersonal communication

Education

HS Diploma

Degree in progress or completed

Tools

EHR/EMR systems

Job description

Company Description

Therapy & Beyond is one of the largest BCBA-owned ABA organizations, founded and led by Dr. Regina Crone, BCBA-D, since 2006. At Therapy & Beyond we approach the needs of each patient both individually and as part of a dynamic interdisciplinary team working with experts in applied behavior analysis (ABA) therapy, speech-language pathology, occupational therapy, and counseling. We love helping individuals reach their full potential by supporting not only the patient but also their family. We are passionate about what we do while remaining true to our defining core values of:

• Putting People First
• Doing Our Best Together
• Making Therapy Fun
• Above All, We grow potential

Job Description

As a Medical Records Specialist, you are the engine behind our financial health, Release of Information (ROI) compliance, and overall operational integrity. You'll be navigating the complexities of the healthcare reimbursement cycle, managing electronic health record (EHR) systems, conducting routine audit readiness reviews, and maintaining strict HIPAA and data privacy protocols. You will act as a vital bridge between our clinics, insurance payers, and third-party requestors to facilitate seamless health information exchange and data interoperability while ensuring patient care is accurately reflected in our billing. This role is based in Flower Mound, TX and will work very closely with multiple departments to ensure strong communication among all stakeholders.

• Medical Records & ROI Workflow Management: Oversee Release of Information (ROI) end-to-end processing, managing incoming and outgoing requests via modern EHR and health information exchange (HIE) platforms, ensuring timely and compliant release to insurance companies, patients, legal entities, and authorized third parties.
• HIPAA, Audit Readiness & Data Privacy Protocols: Maintain full audit readiness and adherence to HIPAA rules, state regulations, and internal privacy policies when handling, releasing, auditing, and archiving protected health information (PHI).
• Strategic Payer Follow-up: Proactively track remits and engage with insurance payers to resolve outstanding issues and ensure timely reimbursement.
• Cross-Functional Collaboration: Collaborate with internal teams to coordinate patient insurance updates, manage claim hold protocols, and support resolution of claim-related issues.
• Queue Management: Effectively prioritize and manage assigned responsibilities within revenue cycle operations while maintaining accuracy and efficiency.
• Revenue Lifecycle Management: Assist with claim submission, adjudication, payment posting, and patient account reconciliation as needed.
• Quality Control: Audit claims for appropriate modifiers and correct billing data points prior to transmission.

Qualifications

• Education: HS Diploma required; Degree in progress or completed preferred.
• Experience: 2 years of Medical Billing/RCM experience (preferred).
• Skills:
  • Deep understanding of medical billing/coding and EMR systems.
  • Proficiency in office technology and multi-line phone management.
  • Exceptional organizational skills with high attention to detail.
  • Strong interpersonal skills for effective team and patient communication.