What are the responsibilities and job description for the Medical Records & Prior Authorization Supervisor position at Rural Health Group, Inc.?
In order to qualify for this position, you must genuinely like and care about people, be kind and compassionate as well as supremely professional, organized and courteous to both patients and staff. You must have excellent skills as a communicator and as a collaborator, and be willing to adapt to circumstances as they change. The individual we seek needs to have thorough knowledge of the complexities involved in a Family Practice office. Supervisory experience is required
The Medical Records and Prior Authorization Supervisor oversees daily operations related to health information management, medical records requests, and insurance prior authorizations. This role ensures compliance with HIPAA, UDS reporting requirements, payer guidelines, and FQHC standards. The supervisor leads a team responsible for processing authorizations, managing record release, managing incoming records, supporting providers, and maintaining the integrity of patient data within the EHR.
Key Responsibilities
- Supervise, train, and evaluate medical records and prior authorization staff.
- Develop workflows and performance standards to maximize efficiency and accuracy.
- Coordinate with clinical, billing, and referral departments to resolve barriers in care authorizations or record retrieval Monitory daily workloads, turnaround times, and quality metrics.
- Oversee processing of prior authorization requests for medications, imaging, procedures, and specialty care.
- Maintain updated payer requirements and communicate change to staff.
- Ensure timely fulfillment of medical records requests in accordance with HIPAA, state laws, and organizational policy.
- Ensure accuracy, security, and integrity of patient health information in the EHR.
- Manage release of information, chart corrections, scanning, and data integrity tasks.
- Support compliance with UDS, PCMH, and other reporting requirements.
- Maintain strict compliance with HIPAA, CMS, HRSA, and payer regulations.
- Participate in internal audits and quality improvement initiatives.
- Develop and update policies and procedures related to health medical records and prior authorizations.
- Teambuilding
Must be able to adhere to the core competencies of the organization, which include:
Good Judgment
Communication/Customer Service/Teamwork
Passion
Honesty
Responsibility
Job-Specific Skill Set
Access to Care
Insurance Verification
Collection of Co-pays and/or Balances
Complete Registration
Presence and Compliance
All duties and responsibilities will be performed in a manner consistent with Rural Health Group's mission, values, guiding principles, and standards.
REQUIREMENTS
• Associate/Bachelor's Degree in Business, Health Administration is preferred • Supervisory experience is required • Excellent verbal and written communication skills • High school diploma or GED • Must have basic knowledge of Medical Records and/or Referral's operations • Ability to multi-task and work efficiently in a potentially fast-paced environment •Possess the tact and attitude necessary to deal effectively with patients, providers, and employees •Willing to travel to other Rural Health Group, Inc. sites to assist other facilities in areas of assigned responsibilities • Ability to apply common sense understanding when carrying out detailed written or oral instructions • Ability to establish and maintain positive, effective, professional relationships with patients, providers, coworkers, and superiors • Possess knowledge of modern office equipment, Microsoft Office software programs, and electronic health record • Must be able to quickly learn to use eClinicalWorks electronic health record system •Must be able to stand for long periods of timeE-Verify Notice: After accepting employment, new hires are required to complete an I-9 form and present documentation of their identity and eligibility to work in the United States.