Medical Records Specialist

Therapy-and-Beyon; Flower Mound (TX); Vor Ort; USD 42.000 - 66.000; Vollzeit

Zusammenfassung

Therapy & Beyond, located in Flower Mound, TX, is seeking a Medical Records Specialist to manage ROI, HIPAA compliance, and billing integrity within our revenue cycle. You will work with EHR/HIE platforms, conduct routine audits, and collaborate across clinics to ensure accurate health information exchange and correct billing data while protecting patient privacy.

Education: HS Diploma required; 2 years of Medical Billing/RCM experience preferred.

Qualifikationen

• HS Diploma required; Degree in progress or completed preferred.
• 2 years of Medical Billing/RCM experience (preferred).
• 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.

Aufgaben

• ROI end-to-end processing, managing requests via EHR/HIE platforms, ensuring timely and compliant release to payers, patients, and third parties.
• Maintain full HIPAA compliance, audit readiness, and data privacy policies when handling PHI.
• Proactively track remits and follow up with insurance payers to resolve issues and reimburse on time.
• Collaborate with internal teams to coordinate patient insurance updates and claim issues.
• Manage revenue cycle queues to maintain accuracy and efficiency in the workflow.
• Assist with claim submission, adjudication, payment posting, and patient account reconciliation as needed.
• Audit claims for modifiers and correct billing data prior to transmission.

Kenntnisse

Medical billing/coding

EMR systems

Office technology

Multi-line phone management

Organizational skills

Interpersonal skills

Ausbildung

HS Diploma

Jobbeschreibung

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, and 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.