Medical Records Specialist

Job Summary: The Verification of Benefits Specialist is responsible for verifying and confirming the benefits and coverage provided by a patient’s insurance plan. This includes ensuring that the services a patient is scheduled to receive are covered under their plan and determining the necessary information to process claims efficiently.  

Key Responsibilities:  

1. Record Management:   

• Organize and file patient medical records in both paper and electronic formats.  
• Update and maintain patient files, ensuring information is accurate and up to date.  
• Retrieve patient records upon request by medical staff or authorized personnel,  

2. Confidentiality and Compliance:  

• Ensure that patient records are kept confidential in accordance with HIPAA (Health Insurance Portability and Accountability Act) and other privacy regulations.  
• Secure and safeguard all medical records, both physical and electronic, to prevent unauthorized access.  

3. Data Entry  

• Input new patient data, medical history, and treatment information into electronic health record (EHR) systems.  
• Perform accurate data entry of medical codes, diagnoses, and other pertinent information into databases.   

4. Coordination:  

• Coordinate with medical personnel, including doctors, nurses, and other healthcare professionals, to ensure proper handling and processing of records.  
• Respond to requests from patients or other healthcare providers for medical records.  

5.  Record Retrieval and Disposition:  

• Retrieve records for patient appointments, procedures, or legal purposes.  
• Dispose of outdated or unneeded medical records in accordance with healthcare regulations.   

6. Customer Service:  

• Assist patients in requesting copies of their medical records and provide instructions on how to obtain them.  
• Answer phone calls and respond to inquiries related to patient records.  

7. Filing and Documentation:  

• Maintain accurate logs of patient record requests and provide reports when necessary.  
• Ensure records are filed correctly, preventing errors and misplacement. 

8. Compliance and Reporting:  

• Stay updated on regulatory changes related to medical records and data management.  
• Help with audits or reviews of patient files to ensure compliance with legal standards.  

• High school diploma or equivalent; some positions may require an associate or bachelor’s degree.   

• Previous experience in medical insurance verification, billing, or coding is preferred.   

• Knowledge of insurance terminology and procedures.   

• Familiarity with medical billing software and Electronic Health Record (EHR) systems.   

• Strong communication skills, both written and verbal.   

• Attention to detail and strong organizational skills.   

• Ability to handle sensitive patient information confidentially.  

Skills:    

• Strong organizational and time-management skills.  

• Attention to detail and accuracy.  

• Knowledge of medical terminology and coding (ICD, CPT).  

• Familiarity with medical records software (EHR/EMR systems).  

• Strong communication skills for working with medical staff and patients.