Medical Records Reviewer

Accounting and Finance El Paso, TX • ID: 1072-374 • Full-Time/Regular Bienvivir All-Inclusive Senior Health (“Bienvivir”) is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly (“PACE”). PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. BENEFITS for Full and Part-time employees who work 30 or more hours per week: We pay 100% of the MEDICAL monthly premiums for Employee Only coverage. We pay 100% of the DENTAL monthly premiums for Employee Only coverage. We provide an affordable VISION monthly premium for Employee + Family coverage. We pay 100% of BASIC LIFE for a benefit amount of $10,000. We offer safe harbor matching contributions for the 403(B) RETIREMENT SAVINGS account. We offer up to fifteen (15) days of PAID TIME OFF based on paid hours per pay period. We offer eleven (11) company-observed PAID HOLIDAYS. We offer education and TUITION REIMBURSEMENT. We offer MILEAGE REIMBURSEMENT. Bienvivir is currently accepting applications for the following position: MEDICAL RECORDS REVIEWER The Medical Records Reviewer works under the general supervision of the Medical Records (MR) Supervisor, is responsible for complying with and enforcing organization and department policies and procedures, the National PACE Association (NPA) standards, Center for Medicare & Medicaid Services (CMS) regulations, HIPAA requirements, and Electronic Medical Record (EMR) guidelines. Responsible for data entry and audits to ensure medical records are accurately documented, securely stored, and accessible to authorized users in compliance with healthcare regulations. Duties include scanning and organizing documents into the EMR, properly categorizing and labeling records, processing record requests, preparing and releasing medical records to nursing home facilities, and maintaining confidentiality and security. Additional duties include covering MR staff responsibilities, assisting with training, and performing administrative, clerical, and project-based tasks. RESPONSIBILITIES: 1. Responsible for data entry into the EMR. Effectively scans, uploads, and audits all relevant paper and electronic documents into the EMR. a. Audits documents for accuracy, completeness, and relevance; perform data entryin the EMR as required. b. Follows EMR and scanning program guidelines in accordance with Compliance and MR policies and procedures. c. Reviews and prepares paper documents for scanning and/or uploading. Review electronic documents to ensure completeness, accuracy, and correct categorization before uploading them to the EMR. Performs audits as needed. d. Identifies and resolves discrepancies by coordinating with appropriate MR staffbefore uploading documents to the EMR. e. Serves as backup for uploading electronic progress notes to the EMR. f. Assists in auditing electronic progress notes uploads. g. Manages the electronic lab process by processing results from contracted laboratories for all centers and promptly entering lab data into the EMR. Maintains tracking logs and ensures timely documentation. 2. Responsible for collecting information related to participants’ inpatient stays, emergency room visits and completes the Service Utilization Report (SUR). a. Collects and tracks hospitalization data from interdepartmental meeting minutes. b. Audits, reviews, and processes hospital medical records, ensuring accuracy, completeness,…