Medical Records Director

General Purpose

The Medical Records Director oversees the management, security, and accuracy of resident health records in compliance with federal, state, and facility regulations. This role ensures timely documentation, supports clinical and administrative staff, and maintains confidentiality and integrity of all medical information within the skilled nursing facility.

Essential Duties

• Manage the creation, maintenance, and storage of resident medical records in accordance with HIPAA and regulatory guidelines
• Ensure timely and accurate documentation of admissions, discharges, transfers, and clinical updates
• Monitor record completion and compliance with facility policies and state / federal requirements
• Coordinate with nursing, therapy, and administrative teams to support documentation needs
• Handle requests for medical records from residents, families, legal representatives, and outside providers
• Oversee electronic health record (EHR) systems and troubleshoot documentation issues
• Train and supervise medical records staff (if applicable)
• Prepare reports and audits for internal and external review
• Maintain confidentiality and safeguard sensitive health information
• Support survey readiness and respond to documentation-related inquiries from regulatory agencies

Supervisory Requirements

The Medical Records Director may supervise medical records staff, providing training, scheduling, and performance oversight to ensure compliance with HIPAA, documentation standards, and facility policies.

Qualification

Education and / or Experience

Physical Demands

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually low to moderate.