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Utilization Management Medical Records Coord

Pinnacle Treatment Centers, Inc.

Pinnacle Treatment Centers, Inc.

Remote
Posted on Mar 20, 2025

Utilization Management Medical Records Coordinator

*Remote position*

We offer competitive salary, full benefits package, Paid Time Off, and opportunities for professional growth.

Pinnacle Treatment Centers is a growing leader in addiction treatment services. We provide care across the nation touching the lives of more than 30,000 patients daily.

Our mission is to remove all barriers to recovery and transform individuals, families, and communities with treatment that works.

Our employees believe we are creating a better world where lives and communities are made whole again through comprehensive treatment.

As the Utilization Management Medical Records Coordinator, you will be responsible for the fulfillment of medical records duties including the processing of payor responses to authorization requests and utilization management in compliance with company policies and processes, records requests, adherence to HIPPA (Health Insurance Portability and Accountability) and 42 CFR Part 2 regulations and all applicable state, federal and local laws pertaining to the maintenance and release of medical records. The Utilization Management Medical Records Coordinator reports to the Director of Utilization Management.

Requirements:

  • Three (3) years of medical records experience.
  • Strong skills in navigating records in electronic medical records systems
  • In-depth knowledge of medical records handling protocols
  • Ensure that payor authorization response records are responded to promptly and are securely stored or destroyed

Preferred:

  • Five (5) years of medical records experience
  • Knowlege and background with managed care and insurance
  • HIPPA Privacy Certification

Responsibilities:

  • Responsible for the management and processing of payor responses to authorization requests.
  • Oversee and coordinate the response to requests for additional information to support authorization requests.
  • Ensure medical record information stored in the company's database is always accurate and current.
  • Maintains tracking mechanisms including database administration and file administration for recordkeeping and information retrieval as directed.
  • Ensure compliance with medical record maintenance standards.
  • Utilizes supervision and consultation appropriately to ensure work within scope of practice.
  • Ensure all processes comply with applicable laws and regulations, including, but not limited to HIPPA, 42 CFR Part 2, and state record retention laws always.
  • Participate in internal meetings regarding medical records and patient information.
  • Attend company and department meetings as required.
  • Attend internal training classes as directed.
  • Complete assigned external training courses and certifications as requested.
  • Exhibit conduct in a manner consistent with company's mission, vision and values.
  • Maintain working knowledge of HIPPA, 42 CFR Part 2, OSHA, Risk Management and Compliance regulations.
  • Practice confidentiality and privacy protocols in accordance with company policies and all applicable laws and regulations.
  • Other duties as assigned.

Benefits:

  • 18 days PTO (Paid Time Off) + 8 paid holidays
  • 401k with company match
  • Company sponsored ongoing training and certification opportunities.
  • Full comprehensive benefits package including medical, dental, vision, short term disability, long term disability and accident insurance.
  • Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP)
  • Discounted tuition and scholarships through Capella University

Join our team. Join our mission.

Education

Required
  • High School/GED or better


Pinnacle Treatment Centers is an equal employment opportunity employer and makes employment decisions based on merit and other legitimate business considerations. We want to have the best available persons in every job. Company policy prohibits unlawful discrimination based on race, traits historically associated with race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), parental leave, national origin, gender, gender identity, gender expression, age, ancestry, physical or mental disability, military and veteran status, marital status, sexual orientation, genetic characteristics or information, political affiliation, non-merit based factors or any other consideration made unlawful by applicable federal, state, or local laws. It also prohibits discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics.