Provider Operations Specialist
Core
Manage the full lifecycle of incoming medical records requests, coordinating with RCM to ensure accurate and timely documentation submission for payers.
Role type
Provider Operations Specialist
Builds
Complete, organized medical documentation packets for payer submissions
Domain
Healthcare operations / Revenue Cycle Management
Deliverable
client delivery
Required skills
Medical records workflow management, HIPAA compliance, EHR system proficiency, deadline tracking, documentation accuracy verification, payer portal navigation, audit response coordination
Preferred skills
Payer audit experience, RPM/RTM billing knowledge, SNF experience, secure health information exchange portal usage, document assembly software proficiency
Responsibilities
Log and track incoming medical records requests across multiple channels; Prepare and consolidate documentation into complete packets; Review packets for accuracy and completeness; Submit packets to requesting payers and confirm receipt; Identify and escalate documentation gaps before submission; Collaborate with RCM and Physician Operations for audit responses; Maintain request tracking logs and digital recordkeeping
Seniority
Individual Contributor