Medical Records Specialist: Behavioral/Mental Health Billing

The Medical Records Specialist oversees daily operations within the medical records department, ensuring patient health information is accurately maintained, securely protected, and available for authorized use in compliance with HIPAA and payer requirements. This role leads distribution and monitoring of medical records workload, supports staff through clear communication and quality oversight, and drives efficient, compliant workflows.

Responsibilities include coordinating workflow among medical records team, overseeing communication with facilities, clients, and payers, reviewing workload distribution, processing and QA of medical records, preparing and submitting record packets, monitoring record status, conducting quality audits, resolving documentation issues, maintaining SOPs and training materials, tracking key metrics, handling administrative processes, securely handling PHI, assisting leadership with staffing and productivity records, promoting HIPAA compliance, coordinating documentation for appeals and clinical reviews, synthesizing timelines and clinical rationale into appeal narratives, managing documentation requests, providing feedback to improve documentation quality, supporting appeals and clinical consultative services, and timely completion of assigned tasks.

Skills required include proficiency with Outlook and Microsoft Suite, working knowledge of payer documentation requirements, HIPAA, and behavioral health terminology.

Education and Experience:

• High school diploma or equivalent required; associate's degree or higher preferred
• 3+ years of experience in medical records, health information management, or related healthcare/behavioral health operations preferred
• Experience with EHR/EMR systems, payer portals, and online databases
• Experience supporting utilization review, appeals, or clinical documentation review strongly preferred