Medical Records and Contracting Clerk

Job Details: Job Location: Chesterton

• Chesterton, IN, Salary Range: Undisclosed, Summary/Objective The 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 North. Shore’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 North. Shore providers and locations.

Essential Functions

Ensures 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 North. Shore’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, Lexis.

Nexis, Better Doctor, and other validation tools. Utilize and navigate Medicaid, NPPES, CAQH and additional sites/portals for providers and North. Shore 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 North.

Shore 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. Competencies Planning and strategic foresight Responsible Decision Making Integrity and accountability Innovation and creativity Adaptive and flexible Leadership, teamwork, and conflict resolution Professionalism and work ethic Empathy Work Environment Work 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. Travel Travel within Northshore locations will be rare for this position. Travel outside of Northshore locations will be rare for this position.

Qualifications

Summary/Objective The 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 North.

Shore’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 North. Shore providers and locations.

Essential Functions

Ensures 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 North. Shore’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, Lexis.

Nexis, Better Doctor, and other validation tools. Utilize and navigate Medicaid, NPPES, CAQH and additional sites/portals for providers and North. Shore 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 North.

Shore 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. Competencies Planning and strategic foresight Responsible Decision Making Integrity and accountability Innovation and creativity Adaptive and flexible Leadership, teamwork, and conflict resolution Professionalism and work ethic Empathy Work Environment Work 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. Travel Travel within Northshore locations will be rare for this position. Travel outside of Northshore locations will be rare for this position.

Required Role Qualifications High School Diploma, Transcripts, or Equivalent Preferred Role Qualifications Bachelor’s Degree in Business, Finance, or Healthcare related studies Two years of experience working within a healthcare setting.

Required Skills

Ability to analyze situations and solve problems at strategic and tactical levels Excellent interpersonal and customer service skills Ability to comprehend, interpret, and apply the appropriate sections of applicable laws, guidelines, regulations, ordinances, and policies Ability to acquire a thorough understanding of the organization's hierarchy, jobs, qualifications, compensation practices, and the administrative practices related to those factors Practiced at organization and planning Employ Critical thinking and problem solving Maintains composure and operates with emotional intelligence Ethical reasoning and decision-making Strong attention to detail Receptive and responsive to feedback Excellent verbal and written communication skills Time management, prioritization, and sense of urgency Proficient with Microsoft Office Suite or related software