Specialty Records Clerk I

The Specialty Records Clerk I plays a crucial role in maintaining accurate and confidential patient records within St. John’s Community Health. This position requires meticulous attention to detail, strong organizational skills, and adherence to regulatory guidelines governing the management of medical records. The Specialty Records Clerk I ensures the efficient retrieval, storage, and dissemination of patient information while upholding patient privacy and confidentiality standards.

What Makes a Good Specialty Records Clerk? An effective Specialty Records Clerk is detail-oriented and highly organized, capable of managing high volumes of documentation while ensuring accuracy and compliance with regulatory standards. They demonstrate strong technical skills in navigating EHR systems and referral portals. Excellent communication and customer service are essential, as they frequently interact with patients, providers, and external partners. A proactive, team-oriented approach combined with problem-solving ability allows them to address issues efficiently and support the seamless flow of patient care documentation.

BENEFITS

• Free Medical, Dental & Vision
• 13 Paid Holidays + PTO
• 403 (B) retirement match
• Life Insurance, EAP
• Tuition Reimbursement
• SEIU Union
• Flexible Spending Account
• Continued workforce development & training
• Succession plans & growth within

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education Requirements:

• High School Diploma or equivalent
• Associate degree or certification in health information management preferred.

Experience and Skills (Required)

• Minimum of 2-3 years of experience in healthcare administration and/or medical records
• Proficiency in medical terminology, record-keeping procedures, and electronic health record (EHR) systems.
• Strong attention to detail and accuracy in data entry and documentation.
• Knowledge of HIPAA regulations and other legal requirements related to patient privacy and confidentiality.
• Bilingual English/Spanish
• Proficient in Microsoft Office and Excel
• Excellent and Strong customer service focus
• Excellent organizational and time management skills, with the ability to prioritize tasks effectively.
• Strong communication and interpersonal skills, with the ability to interact professionally with patients, healthcare providers, and colleagues.
• Ability to work independently and collaboratively in a fast-paced healthcare environment.
• Proficiency in using electronic health record (EHR) and practice management software. eClinicalWorks experience is a plus.
• Good judgment
• Resourcefulness in problem-solving
• Performs other duties as assigned by the Referral Manager & Analyst

Additional Requirements:

• Reliable transportation and flexibility to travel between Los Angeles, San Bernardino, and Riverside Counties as needed.
• Flexibility to work evenings and weekends as needed for community events.

Essential Duties & Responsibilities

Performs a combination, but not necessarily all, of the following duties:

Referral Management

• Ensure PCP receives in a timely manner the specialty report and is scanned in the patient’s medical records.
• Acts as a Provider educator to ensure that the Provider is aware of referral timeframes and communicates referral information to the patient regarding his/her condition and the patient is educated.
• Ensures compliance with regulatory requirements and application of clinical decision support criteria for care management activities deemed by Federal, State, and other regulatory and accreditation agencies.
• Meets productivity referrals follow-ups of an average of 95+ referrals daily, including scanned reports.
• Modifies CPT/ICD-10 Codes and extends authorizations as needed.
• Assist with scanning reports from the Referrals Centralized Fax inbox as needed.

Record Management

• Organize, index, and maintain both electronic and paper-based medical records according to established protocols and regulatory requirements.
• Ensure accurate labeling, filing, and tracking of patient records to facilitate easy retrieval and efficient record management.
• Update patient records with new information, including diagnostic tests, treatment plans, and medication changes.
• Utilizing Web Portals such as Medpoint, eConsult, Optum, IEHP, Lanes, etc. To obtain specialty/Radiology records.

Data Entry and Documentation

• Enter patient data into electronic health record (EHR) systems with precision and attention to detail.
• Verify the accuracy and completeness of patient information, including demographic details, insurance information, and medical history.
• Review medical documentation for completeness, accuracy, and compliance with organizational and regulatory standards.

Release of Information

• Process requests for release of medical records in accordance with HIPAA regulations and organizational policies.
• Verify the identity and authorization of individuals requesting access to patient records.
• Maintain detailed logs and documentation of all record requests and disclosures.
• Patient Communication:
• Communicate with patients to explain the referral process, including required paperwork, authorizations, and appointment scheduling.
• Address patient inquiries, concerns, and complaints regarding referrals with empathy and professionalism.

Insurance Liaison

• Stay updated on changes in insurance policies, regulations, and reimbursement guidelines affecting referral processes.

Confidentiality and Security

• Adhere to strict confidentiality protocols to safeguard patient privacy and protect sensitive medical information from unauthorized access or disclosure.
• Maintain compliance with HIPAA regulations and other relevant privacy laws governing the handling of patient health information.
• Monitor access to patient records and report any potential breaches or security incidents to appropriate personnel.

Communication and Collaboration

• Collaborate with healthcare providers, administrative staff, and other team members to ensure accurate and timely record management.
• Respond to inquiries from healthcare professionals, patients, and external parties regarding medical records and documentation.
• Communicate effectively with internal stakeholders to address record-related issues and resolve discrepancies.
• Interacts with entities (IPA, Health Plans, etc.) Medical Management staff, including Medical Directors and St John’s Health Services Network, Clinic Manager, and other staff.
• Seeks assistance from the Referral Manager & Analyst when unable to follow up on assigned referrals to avoid backlog and the clinical consequences of delays
• Notify the Referral Manager & Analyst when tasks are completed before the end of the business day to assist other team members if help is needed.
• Required to work one Saturday per month or as needed.
• Assist the Referral Call Center as needed.

Quality Assurance and Compliance

• Participate in quality assurance initiatives to ensure the accuracy, integrity, and completeness of patient records.
• Facilitate communication between patients, primary care providers, and specialty offices to support appointment scheduling.
• Support the Referral Compliance Specialist with timely completion of pre-operative tasks, including follow-up referrals, diagnostic testing, or other pre-operative requirements directed by the Referral Manager & Analyst.
• Assist with patient navigation by providing updates on referral and authorization status, helping patients understand the next steps in their care journey and directing them to appropriate resources when needed.
• Support the Referral Call Center with patient calls as needed.
• Perform additional clerical and administrative duties as required

St. John's Community Health is an equal opportunity employer.