Rev Cycle Medical Records Case Mgr

The Revenue Cycle Medical Records Case Manager will successfully obtain necessary medical documentation by collaborating with and serving as a primary liaison between in-house billing operations, customer experience groups, and clinic medical records departments. They will provide expert review and interpretation on a case-by-case basis, navigating and extracting data from multiple versions of electronic medical records, including EPIC. The role involves serving as a source of knowledge for medical records review and interpretation, including in-depth review of provider progress notes and charts, identifying critical data points highlighting patient criteria meeting medical necessity, and summarizing information for health insurance companies. A thorough understanding of oncology and organ health terminology, including chemotherapy and immunotherapy treatments, is required. The Case Manager will develop and cultivate ongoing working relationships with other departments impacting revenue cycle performance, participate in weekly meetings, case reviews, and continuing education, prioritize performance initiatives, follow department procedures, and ensure all activities are documented within compliance standards. This role also requires access to Patient Health Information (PHI) and completion of HIPAA and PHI privacy training.