The Medical Records Manager supports the Centers for Medicare & Medicaid Services (CMS) Payment Error Rate Measurement (PERM) program. This position is responsible for assisting the Project Director in project scheduling and timely completion of deliverables; oversees the PERM Medical Records Requests tasks, including call center operations within the established budget; and manages office operations. This position provides direct supervision of Technical Writer(s), Administrative Specialist(s), Assistant Medical Records Manager, Records Processing Technicians and indirect supervision of the Customer Service Representatives.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Essential duties and responsibilities include the following. Other duties may be assigned.
Responsible for the integration of CNI Core Competencies into daily functions, including: commitment to integrity, knowledge / quality of work, supporting financial goals of the company, initiative / motivation, cooperation / relationships, problem analysis / discretion, accomplishing goals through organization, positive oral / written communication skills, leadership abilities, commitment to Affirmative Action, reliability / dependability, flexibility and ownership / accountability of actions taken.
Communicates directly with and supports the Centers for Medicare and Medicaid Services (CMS) Payment Accuracy and Reporting Group (PARG).
Collaborates with State Medicaid Representatives, appropriately categorizes issues for resolution, and provides guidance and support from cycle kick-off through closing.
Leads Review Contractor systems training for states. Provides technical guidance to State PERM Representatives.
Responsible for collaborating with PERM Contractors (Statistical Contractor and Eligibility Review Contractor) to achieve project goals.
Assists the Project Director in Eligibility Review Contractor reintegration efforts.
Assists the Project Director in the management of project Statement of Work (SOW), ad-hoc deliverables, internal and external meetings.
Reports on the status of deliverables and Medical Records Requests (MRR) task.
Manages the MRR tasks and budget.
Responsible for meeting MRR project milestones.
Manages office operations.
Responsible for regulatory compliance for Health Insurance Portability and Accountability Act (HIPAA) and Centers or Medicare and Medicaid Services (CMS) security requirements with respect to medical records management and call center operations.
Ensures accurate intake, processing, and storage of records and disposal of paper records after scanning has been completed and verified.
Provides oversight and direction for the documentation collection protocols necessary for timely completion of requirements.
Maintains the confidentiality of all work products.
Develops and monitors quality assurance effectiveness measures for all functions.
Develops necessary reports to monitor operations effectively and provides quality assurance for ad hoc activities to support process improvements.
Provides support, maintenance and distribution of required reports including interpretation, validation, creating an audit trail, and problem resolution.
Ensures work instructions for each task are current and posted to electronic document libraries.
Fulfills administrative requirements, validates outputs to assure data quality, and delivers quality services and products to customers.
Identifies and supports definition of requirements for system enhancements.
Collaborates with other Task Leaders supporting the contract to facilitate timely completion of deliverables.
Maintains excellent professional relationships with client team and PERM State representatives.
Provides support and is a backup to the Sample Unit Coordination task.
Responsible for aiding in own self-development by being available and receptive to all training made available by the company.
Plans daily activities within the guidelines of company policy, job description and supervisor’s instruction in such a way as to maximize personal output.
Responsible for keeping own immediate work area in a neat and orderly condition to ensure safety of self and coworkers. Will report any unsafe conditions and/or practices to the appropriate supervisor and human resources. Will immediately correct any unsafe conditions to the best of own ability.
EDUCATION / EXPERIENCE
Bachelor's degree and a minimum of five (5) years relevant experience, or equivalent combination of education / experience. Experience centered on electronic medical records or electronic transmission of medical records. Experience analyzing problems of a management or technical nature. Three years supervisory/managerial experience related to file/record management.
CERTIFICATES / LICENSES / REGISTRATION
JOB SPECIFIC KNOWLEDGE / SKILLS / ABILITIES
Knowledge of Information Management Systems, claims processing, Medicaid and/or Medicare Programs
Proficient in MS office and Adobe Acrobat Pro
Knowledge of project deliverables and scheduling
Technical knowledge in records management
Strong communication and organizational skills
Self-directed Team Leader encouraging process improvements
Excellent supervisory/management skills
Skilled in facilitating teamwork and coordinating efforts for the successful achievement of goals
Ability to manage multiple tasks simultaneously
Excellent verbal and written communication skills
Ability to make sound, well-informed and objective decisions, perceives the impact and implications of decisions
Ability to organize work and set priorities
Ability to work effectively both independently and in a team environment
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.