Health Information Specialist

Health Information Specialist

The Health Information Specialist maintains the accuracy, completeness, accessibility, and compliance of patient records across the practice. The role brings together medical records management, clinical documentation auditing, intake and patient outreach, provider credentialing, prior authorization support, and quality and compliance work in a psychiatry and behavioral health setting. The specialist works closely with psychiatric providers, clinical leadership, and administrative teams to support high-quality, compliant, and well-documented patient care.

The practice employs two Health Information Specialists who share this job description. Primary ownership of individual functions is assigned by leadership and may rotate to provide cross-coverage.

Key Responsibilities

• Process and track all incoming and outgoing medical records requests
• Handle legal documentation requests related to medical records, including subpoenas and other formal requests
• Manage the HIS inbox and respond to patient and staff inquiries related to records and documentation
• Manage the patient forms inbox and complete forms for provider review
• Manage incoming and outgoing faxes
• Notify primary care providers when a referred patient begins services with the practice
• Maintain and organize patient ID documentation and other records in Dropbox, and upload documents to the correct patient chart

Clinical Documentation Audit and Compliance

• Conduct regular chart audits and provider note compliance checks to verify documentation is complete and meets insurance and regulatory requirements
• Flag missing or incomplete documentation and coordinate with providers and administrative staff to resolve it
• Maintain strict confidentiality and compliance with HIPAA, payer, regulatory, and organizational policies

Intake and Patient Documentation

• Ensure intake paperwork is fully completed before patients are seen, and follow up with patients when it is not
• Connect with patients requiring completion of new or updated intake and clinical paperwork
• Connect with patients turning 18 to complete and sign their own documentation

Patient Outreach and Re-engagement

• Send next-day texts to patients who no-show and assist with rescheduling
• Connect with patients who have missed 3 consecutive appointments
• Conduct 3-month outreach to patients not seen within the past three months to support scheduling and re-engagement
• Prepare and send discharge letters, including annual discharge letters to inactive patients, in accordance with behavioral health policies and continuity-of-care requirements

Provider Credentialing and Payer Enrollment

• Own and manage provider credentialing and termination processes with insurances
• Manage provider CAQH profiles, updating and attesting as required
• Attest the organization and its providers with insurances every 90 days
• Liaise with the practice's malpractice vendor to add new providers to coverage and remove providers leaving the practice
• Maintain LabCorp, Quest, GeneSight, and CRISP accounts

Prior Authorizations

• Support the Prior Authorizations team and process prior authorizations for medications as needed

Quality and Process Improvement

• Assist in developing and maintaining audit tools, compliance workflows, and documentation
• Support quality improvement initiatives related to patient access, retention, and documentation compliance
• Maintain task data for monthly Quality Team dashboard updates

Other

• Additional duties as assigned

Qualifications

Required

• Associate's degree (minimum)
• Experience in behavioral health, psychiatry, healthcare administration, compliance, or medical records
• Strong attention to detail and ability to manage sensitive clinical information
• Proficiency with electronic health records (EHR) and standard office software

Preferred

• Bachelor's degree in Healthcare Administration, Psychology, Health Information Management, or a related field
• Familiarity with behavioral health documentation standards, audits, and prior authorization processes
• Knowledge of HIPAA and behavioral health confidentiality regulations
• Experience with provider credentialing, CAQH, and payer enrollment

Skills and Competencies

• Strong analytical and organizational skills
• Clear and professional written and verbal communication
• Ability to collaborate effectively with psychiatric providers and clinical teams
• Discretion and sound judgment when handling confidential behavioral health information
• Experience completing prior authorizations for medications
• Strong general computer skills, including Excel with data manipulation, Word, and Google Workspace

Work Schedule

• Full-time, salaried position
• 9:30am – 6:00pm Monday to Friday
• Location: hybrid