Medical Billing Specialist jobs in California

Position: Medical Record Review Specialist

Reports To: Medical Records Department Supervisor

Employment Status: Full-Time

FLSA Status: Non-Exempt

Job Summary:

The Medical Record Review Specialist is responsible for conducting thorough reviews of behavioral health medical records to ensure accuracy, compliance, and completeness. This role collaborates closely with other departments, including billing and clinical services, to uphold the highest standards of documentation for our clients.

Duties/Responsibilities:

• Conducts regular reviews of client medical records for accuracy, completeness, and compliance with industry standards and regulatory requirements.

• Identifies inconsistencies, discrepancies, or missing documentation within the records.

• Ensures that all documentation supports the billing claims made.

• Provides detailed feedback to providers and other relevant personnel regarding documentation quality, areas of improvement, and potential risks.

• Generates regular reports on review findings, including trends, areas of concern, and recommendations for training or process improvement.

• Works closely with billing teams to address any documentation concerns that could impact the billing process.

• Collaborates with the clinical services team to ensure clarity and understanding of documentation requirements.

• Stays updated with changes in behavioral health documentation standards, regulatory requirements, and best practices.

• Participates in internal training sessions and provides insights to develop training materials based on review findings.

• Maintains a systematic method of tracking reviewed records, findings, and feedback given.

• Uses electronic health record systems and billing software proficiently.

• Contributes to the continuous improvement of internal processes, ensuring that the company's quality assurance methods are both efficient and effective.

• All other duties as assigned.

Required Skills/Abilities:

• Strong attention to detail and accuracy.

• Proficiency in electronic health record systems and billing software.

• Strong communication and interpersonal skills.

• Ability to work independently and as part of a team.

• Problem-solving and critical thinking skills.

Education and Experience:

• High School Diploma or equivalent required.

• Bachelor’s degree in healthcare administration, nursing, or a related field preferred.

• Relevant certifications in medical coding or health information management preferred.

• A minimum of 2 years of experience in medical records review, preferably within the behavioral health sector.

• Familiarity with behavioral health billing is preferred.

• Knowledge in Behavioral Health Assessments such as ASAM, LOCUS, and CALOCUS.

• Comprehensive understanding of medical terminology, especially within the behavioral health sector.

Physical Requirements and Work Environment:

The physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to stand, sit; talk, hear, and use hands and fingers to operate a computer, reach, stoop, kneel.
• Light to moderate lifting of up to 15 pounds is required.
• Prolonged periods sitting at a desk and working on a computer.

The work environment characteristics described here are representative of those encountered while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The information in this document is not intended to constitute a contract of employment, or create contractual rights of any kind between the Company and its employees. At CodeMax Medical Billing employees are employed “at will.” This means that employees may terminate their employment at any time and for any reason, and that the company has the right to terminate employees on the same basis. The Company reserves the right to modify, suspend, change or terminate the information in this document at any time, with or without prior notice.