Rev Cycle Medical Records Case Manager – Temp
Natera
Job Summary
Natera is hiring a Remote Revenue Cycle Medical Records Case Manager to obtain medical documentation, review clinical records, support medical necessity determinations, analyze patient records, and assist revenue cycle operations through detailed documentation review and insurance coverage research.
Job Description
The Revenue Cycle Medical Records Case Manager serves as a liaison between billing operations, customer experience teams, and healthcare providers to obtain and review medical documentation supporting medical necessity requirements. This role requires extensive review of provider notes, medical records, insurance coverage criteria, and clinical documentation to support reimbursement and claims resolution efforts.
The position involves reviewing complex patient records, extracting critical clinical information, interpreting medical documentation, and ensuring compliance with payer guidelines and regulatory requirements. Strong knowledge of revenue cycle operations, insurance coverage policies, and medical terminology is essential.
### Key Responsibilities
* Obtain medical records and supporting documentation
* Review provider notes and patient charts
* Analyze medical necessity requirements
* Interpret insurance coverage guidelines
* Collaborate with billing and customer experience teams
* Navigate electronic medical record systems including EPIC
* Summarize clinical findings for insurance carriers
* Review oncology and organ health documentation
* Support revenue cycle performance initiatives
* Maintain HIPAA and PHI compliance
* Document case activity accurately
* Participate in case reviews and performance meetings
### Requirements
* 3+ years healthcare-related experience
* Medical records review experience
* Knowledge of medical terminology
* Understanding of medical billing systems
* Strong analytical and critical thinking skills
* Experience interpreting clinical documentation
* Ability to work independently
* Excellent organizational skills
* Experience with electronic medical records
### Preferred Qualifications
* Bachelor’s Degree
* LPN, RN, BSN, or Healthcare Administration background
* Oncology experience
* Transplant experience
* Appeals and denials experience
* Insurance collections experience
* EPIC experience
* Revenue Cycle Management experience
### Benefits
* Remote work
* Competitive healthcare benefits
* 401(k)
* Dental and Vision Insurance
* Career growth opportunities
* Professional development
* Paid leave programs
### Phone Level Breakdown
* Medical records review: High
* Documentation analysis: High
* Insurance research: Moderate
* Provider communication: Moderate
* Customer interaction: Moderate
### Best Fit For
Candidates with experience in medical records, healthcare administration, revenue cycle management, insurance appeals, denials management, utilization review, case management, medical billing, coding support, and clinical documentation review.