Medical Records Clerk

Job Code: MR - 103
Revision Date: September 18, 2026

$14.67 hourly; $30,507 annually

Non-Exempt

We are an agency committed to innovative behavioral health services in trauma-informed care that promote healing and recovery to instill a sense of empowerment and foster a lifelong sense of resilience.

The purpose of this job is to perform a variety of routine and complex clerical tasks supporting the Medical Records Department. Maintains client health information and ensures that it is complete and accurate. Responsibilities include timely conversion, accurate entry of data from paper medical record charts to electronic medical record. Manages incoming and outgoing records requests.

This class works under close to general supervision according to set procedures but determines how or when to complete tasks.

The functions listed below are those that represent the majority of the time spent working in this position. Management may assign additional functions related to the type of work of the position, as necessary.

• Arranges, sets-up records location in the computer and closes cases according to approved procedures.
• Performs administrative duties to include compiling reports, equipment check-in/check-out, and requests and receives external documents.
• Scans progress notes, lab results, evaluations, medication list, ITP/IPP's and other related client material.
• Performs routine keyboarding of correspondence, memorandum, and other material from typed, drafted, printed, written, copy or verbal instruction.
• Add information received in records and acts appropriately for disposition.
• Scans documents on a daily basis; maintains documents in a filing order to allow for easy retrieval. Index records into asset management system. Transports records in compliance with HIPAA regulations.
• Charts will be thinned as needed according to the policy and procedures of the record department.
• Maintains and organizes all records offices to ensure information availability and integrity.
• Assists clients to complete release of information authorization forms and other documents as deemed appropriate to medical records utilizing ultra-sensitive exchange electronic forms.
• Performs assigned tasks in a responsible, reliable, and cooperative manner and treats others with fairness, mutual respect, dignity, and trust.
• Responsible for processing release of information (ROI) requests utilizing the Ultra-Sensitive Exchange Continuity of Care Documents/Health
• Information Exchange, in compliance with organizational policies, HIPAA and State regulations, to ensure the highest quality client care is provided while maintaining confidentiality of our client's protected health information. At all times, ensures that only authorized individuals have access to the patients' health information.
• Purges records in accordance with policy and procedures and in accordance with acceptable requirements.
• Process reports of death, client separations, requesting death certificates, autopsy reports, and notifies the designated death review associate.
• Performs HIPAA inspections throughout the clinics to identify any risks or vulnerabilities to ensure compliance in protecting the integrity of protected health information.
• Maintains compliance with all Joint Commission training requirements relevant to job duties, including but not limited to those dealing with use of restraints and physical holding of individuals receiving services.
• Performs other duties as assigned.

Requires High School diploma or GED equivalent supplemented by one (1) year of experience in medical records; or an equivalent combination of education, training and experience that provides the required knowledge, skills, and abilities.

Experience with trauma-informed services; cognitive behavioral therapies, including Dialectical Behavioral Therapy (DBT); and motivational therapies including the use of incentives, preferred.

Knowledge of trauma-informed theories, principals, and practices (includes multi-faceted understanding of concepts such as community trauma, intergenerational and historical trauma, parallel processes, and universal precautions), preferred.

Performs sedentary work that involves walking or standing some of the time and involves exerting up to 10 pounds of force on a regular and recurring basis or sustained keyboard operations.