Patient Grievance & Health Records Specialist

Overview
PATIENT GRIEVANCE & HEALTH RECORDS SPECIALIST
We are Array Behavioral Care, where we envision a world where loved ones never struggle to access behavioral health services that support their wellness. Our mission is to transform access to quality behavioral care through innovative applications of technology. Come be a part of our organization where you can help us lead the way in providing remote high-quality behavioral healthcare to those who need it most.
Organizational Overview
Array Behavioral Care is the leading and largest telepsychiatry service provider in the country with a mission to transform access to quality, timely behavioral health care. Array offers telepsychiatry solutions and services across the continuum of care from hospital to home with its OnDemand Care, Scheduled Care and AtHome Care divisions. For more than 20 years, Array has partnered with hundreds of hospitals and health systems, community healthcare organizations and payers of all sizes to expand access to care and improve outcomes for underserved individuals, facilities, and communities. As an industry pioneer and established thought leader, Array has helped shape the field, define the standard of care and advocate for improved telepsychiatry-friendly regulations.
Position Summary
Array is seeking a Patient Grievance and Health Records Specialist to with Quality and Clinical Leadership. This person will process health record requests from stakeholders (payors, patients, clinicians, partners, etc.) Tasks may include but are not limited to scanning and processing documents, preparing charts for review, responding to ROI requests, logging and tracking requests, authorizations, releases from EHR, replying to stakeholders in a professional manner, and managing tasks within state and federal regulations.
Responsibilities
Position Responsibilities

• Respond to ROI (release of information) requests for medical records in a timely manner, tracking all requests
• Validate requests and authorizations for the release of medical information with support of Compliance department
• Ensure that clinical documentation of the services provided to our patients is correct, following guidelines set by Quality Department
• Prepare charts for regulatory review as required
• Follow all HIPAA regulations

• Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from health plan members, patients, providers and related outside agencies to ensure that internal and/or regulatory timelines are met
• Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions to determine response; assures timeliness and appropriateness of responses per state, federal and company guidelines
• Apply contract language, benefits, and review of covered services
• Responsible for contacting the member/payor through written and verbal communication.
• Prepares appeal summaries, correspondence, and document findings. Include information on trends if requested
• Composes all correspondence and appeal/dispute and or grievances information concisely and accurately, in accordance with regulatory requirements

Qualifications
Position Requirements

• Associate degree; Bachelors preferred
• 2 - 3+ years of related, professional work experience required, preferably behavioral healthMedical Records experience preferred
• Knowledge of medical and behavioral health terminology
• Prior auditing experience preferred
• Customer service experience preferred
• Proficiency in MS Office (word processing, and database/spreadsheet) required
• Experience in comprehending and producing grammatically accurate and error-free business correspondence required
• Excellent communication (verbal, written, presentation, interpersonal) skills required
• Excellent problem solving, and analytical skills required
• Ability to work under pressure and deliver complete, accurate, and timely results required
• Strong time management, organizational, analytical, investigative, and problem-solving skills required
• Familiarity with state and federal regulations require

Position Logistics

• Hybrid position, Mt. Laurel, NJ office
• Full-time employment
• Reports to Director, Quality Assurance

At Array we strongly value diversity and are committed to equal opportunity and non-discrimination in all policies and practices, including the area of employment. We are proud to be an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, Veteran status, gender identity or expression, marital status, genetic information, or any other legally protected status.