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Researches and develops the pre-certification insurance policy standards and criteria used by case management and utilization reviewers that will ensure that requested medical services are appropriate and medically necessary. Collaborates with medical professionals to resolve questions about policy development and standards. Assigns correct ICD, CPT, or other coding assignments for medical procedures that support policy standards in claims systems. Provides expertise and solutions to users regarding the appropriate coding for claims. Has broad knowledge of medical coding systems. May require a more...



Alternate job titles: Health Information Records Director

Directs medical record-keeping operations and healthcare information management to ensure secure, accurate, and reliable patient information management that complies with data and privacy regulations. Develops policies and procedures and conducts continuous improvement activities to ensure effective and compliant record management. Implements digital technologies and tools to gain efficiencies, facilitate record retrieval, and ensure secure storage. Provides training for medical records staff and information resources to end-users. Coordinates with clinical and technical professionals to maint more...


Alternate job titles: Health Information Records Administration Manager | Medical Records JCAHO Compliance Manager

Manages medical record-keeping operations and healthcare information management to ensure secure, accurate, and reliable patient information management that complies with data and privacy regulations. Follows established policies and procedures to ensure effective and compliant record management, makes suggestions for process improvements. Implements digital technologies and tools to gain efficiencies, facilitate record retrieval, and ensure secure storage. Provides training for medical records staff and information resources to end-users. Coordinates with clinical and technical professionals more...


Alternate job titles: Manager of Medical Records Coding | Medical Records Coding Trainer

Supervises and trains a team of medical coders to ensure medical records are coded with accuracy and completeness. Ensures medical records coding operations follow the latest guidelines and compliance standards. Maintains required documentation and confidentiality of patient records. Implements processes for coding operations that support the needs of other healthcare partners. Develops and maintains up-to-date knowledge of the latest ICD and CPT coding versions and ensures coders receive updates and training on classification or guideline changes. Is a certified medical coder and the exact ty more...



Alternate job titles: Medical Records Manager | Health Information Records Administration Manager

The Medical Records JCAHO Compliance Manager is responsible for the accuracy, completeness, confidentiality, and security of all healthcare information. Manages and oversees the medical records function within a healthcare organization. Being a Medical Records JCAHO Compliance Manager requires a bachelor's degree. Ensures all the healthcare information management processes and practices comply with applicable JCAHO and other required regulations and policies. In addition, Medical Records JCAHO Compliance Manager typically reports to head of a unit/department. Requires Registered Health Informa more...


Supervises routine medical record-keeping operations and healthcare information management to ensure secure, accurate, and reliable patient information management that complies with data and privacy regulations. Follows established policies and procedures to ensure effective and compliant record management, makes suggestions for process improvements. Implements digital technologies and tools to gain efficiencies, facilitate record retrieval, and ensure secure storage. Provides training for medical records staff and information resources to end-users. Coordinates with clinical and technical pro more...



Alternate job titles: Patient Medical Records Coordinator

Organizes, files, and retrieves patient medical records. Performs data entry, file maintenance, and other clerical processes. Follows established policies and procedures to ensure effective and compliant record management. Fulfills information requests for retrieval and printing of medical records from storage or archives. Ensures the privacy and security of all patient records. Requires a high school diploma. Typically reports to a supervisor. Works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. Typically requires 1-3 years of related ex more...


Alternate job titles: Health Information Records Administration Supervisor | Health Information Records Supervisor | Medical Records JCAHO Compliance Supervisor

Supervises routine medical record-keeping operations and healthcare information management to ensure secure, accurate, and reliable patient information management that complies with data and privacy regulations. Follows established policies and procedures to ensure effective and compliant record management, makes suggestions for process improvements. Implements digital technologies and tools to gain efficiencies, facilitate record retrieval, and ensure secure storage. Provides training for medical records staff and information resources to end-users. Coordinates with clinical and technical pro more...


Alternate job titles: Medical Records Clerk | Patient Medical Records Coordinator

The Medical Records Technician performs data entry, file maintenance, and other clerical processes. Organizes, files, and retrieves patient medical records. Being a Medical Records Technician fulfills information requests for retrieval and printing of medical records from storage or archives. Follows established policies and procedures to ensure effective and compliant record management. In addition, Medical Records Technician ensures the privacy and security of all patient records. Requires a high school diploma or equivalent. Typically reports to a supervisor. Being a Medical Records Technic more...



Alternate job titles: Membership Enrollment Data Administrator | Membership Records Coordinator

Maintains the membership database for organization. Processes and inputs member enrollments and renewals to database. Performs periodic audits to ensure member records are up-to-date coded correctly. Resolves any member issues with enrollment. Designs and generates routine and ad-hoc reports for management review. Coordinates maintenance and upgrades to database software. May require a bachelor's degree or equivalent. Typically reports to a manager or head of a unit/department. Work is closely managed. Works on projects/matters of limited complexity in a support role. Typically requires 0-2 ye more...


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