Medical Records Reviewer

Medical Records Reviewer

Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly ("PACE").

PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible.

Bienvivir is currently accepting applications for the following position:

Medical Records Reviewer

The Medical Records Reviewer works under the general supervision of the Medical Records (MR) Supervisor, is responsible for complying with and enforcing organization and department policies and procedures, the National PACE Association (NPA) standards, Center for Medicare & Medicaid Services (CMS) regulations, HIPAA requirements, and Electronic Medical Record (EMR) guidelines. Responsible for data entry and audits to ensure medical records are accurately documented, securely stored, and accessible to authorized users in compliance with healthcare regulations. Duties include scanning and organizing documents into the EMR, properly categorizing and labeling records, processing record requests, preparing and releasing medical records to nursing home facilities, and maintaining confidentiality and security. Additional duties include covering MR staff responsibilities, assisting with training, and performing administrative, clerical, and project-based tasks.

Responsibilities:

1. Responsible for data entry into the EMR. Effectively scans, uploads, and audits all relevant paper and electronic documents into the EMR.

2. Responsible for collecting information related to participants' inpatient stays, emergency room visits, and completes the Service Utilization Report (SUR).

3. Responsible for processing medical records for Visitors.

4. Responsible for initiating, verifying, and tracking medical record requests for participants' hospitalization stays, emergency room visits, and visitors' previous medical history in compliance with departmental and regulatory standards.

5. Responsible for preparing and auditing medical records to be sent to Nursing Home Facilities upon admission and monthly thereafter for the duration of the participant's stay at the facility in accordance with MR standard operating procedures and Interdisciplinary team (IDT) policy.

6. Provides backup support and coverage for MR staff during absences, including the following responsibilities:

7. Meetings:

8. Additional Duties as Assigned:

Qualifications / Requirements:

1. High school diploma or GED equivalent required.
2. Certified from an accredited technical/trade school in the medical field preferred.
3. Two (2) years of work experience in the medical field preferred.
4. Experience with electronic health records programs, scanning procedures, and familiarity with HIPAA, CMS, TMHP and other regulatory requirements preferred.

Knowledge, Skills, and Abilities:

1. Knowledge of HIPAA, Electronic Medical Record (EMR) systems, and compliance standards related to management, privacy, release, and disclosure of medical records preferred.

2. Extensive medical terminology and clinical documentation knowledge.

3. Quality assurance, attention to detail, and analytical skills.

4. Strong data entry and typing skills, fast and accurate.

5. Computer skills. Competence in organizing and accessing electronic health records; skilled in Microsoft Office applications (Word, Excel, Outlook).

6. Effective communication and telephone skills, courteous and professional interactions with internal and external stakeholders.

7. Good judgment, excellent problem-solving abilities, and decision-making skills.

8. Ability to follow directions, instructions, policies, and procedures in any format, including verbal and written.

9. Ability to manage multiple tasks efficiently, prioritize responsibilities, follow up on pending work and meet deadlines. Advanced organization and time management abilities.

10. Ability to work independently and as a team member. Ability to maintain effective working relationships with staff at all levels.