Medical Records Review Specialist

Overview

About South Bend Orthopaedics (SBO)

Founded in 1947, South Bend Orthopaedics (SBO), a proud partner of OrthoAlliance, provides specialized care for musculoskeletal surgery, orthopedic rehabilitation and the treatment of sports and work-related injuries. SBO has served northern Indiana and southwest Michigan for decades and has been the orthopaedic surgeons for the University of Notre Dame Athletics Department since 1949. Services include joint replacement, sports medicine, upper and lower extremity surgery, pain management, imaging and physical and occupational therapy. With 20 physicians and a team of advanced practitioners, SBO delivers comprehensive orthopedic care across multiple locations. As part of OrthoAlliance – an organization within SCA Health – SBO is connected to a broader network dedicated to advancing patient care and expanding access to quality-driven orthopedic services.

At SCA Health, we believe health care is about people – the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization. 

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.  

What sets SCA Health apart isn’t just what we do, it’s how we do it. Each decision we make is rooted in seven core values: 

• Clinical quality 
• Integrity 
• Service excellence 
• Teamwork 
• Accountability 
• Continuous improvement 
• Inclusion 

Our values aren’t empty words – they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.    

At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.

Your ideas should inspire change. If you join our team, they will. 

Responsibilities

Essential Functions

• Multi-tasking and handling diverse and complex claim cases including worker’s compensation claims, automobile accidents, personal injury, and short and long term disability.
• Obtain legal documents and medical records, summarize medical records, organize and prepare records to be delivered to physician for review.
• Preps IME’s, peer reviews and record reviews including recording, reviewing and appropriate summary information. Prep, print, organizes and delivers physical copies of all paperwork to the physicians in a timely manner.
• Understands medical terminology to assist clients and physicians.
• Knowledgeable of Work Comp, Automobile, disability, and Personal Injury Claims.
• Knowledgeable of Physician protocols, IME’s, record reviews and peer reviews.
• Maintains strict confidentiality required related to medical records and other data.
• Participates in professional development efforts to ensure currency in health care practices and trends.
• Other duties as assigned.

Qualifications

Education:  High school diploma or equivalent required.  Additional certification or related educational experience preferred.

Experience:  Minimum cumulative of three years of experience in workers compensation, medical chart review and/or medical records

Skills and Abilities

• Ability to communicate clearly and professionally, possessing excellent phone skills in order to establish/maintain trust of current clients (third party vendors, attorneys, insurance companies).
• Needs to maintain a cooperative relationship with patients, physicians, and staff.
• Must be able to efficiently gather insurance and/or account information.
• Must be able to navigate and comprehend computer software systems in an office setting, prefer 50 wpm.
• Must maintain knowledge of clinic, insurance contract policies and procedures and medical terminology as related diverse claims.

Physical and Mental Demands

• Able to sit for up to 8 or more hours/day while doing computer input and responding to phone questions.
• Work requires high speed and a degree of accuracy.
• Must be able to view computer screens for long periods and have manual dexterity using keyboard.
• Performs complex tasks requiring independent judgement, exercising discretion.
• Able to handle difficult and sensitive information related to claims and dealing with dissatisfied physicians or clients.
• The job holder must demonstrate current competencies applicable to job position.

Environmental Work Conditions

Office setting with minimal exposure to communicable diseases.

USD $20.50/Hr. USD $25.00/Hr.