It’s your choice, choose AdvancedHEALTH. AdvancedHEALTH specializes in medical billing services, accounts receivable, and information management for medical practices. Join our growing team. We promote a fun and friendly work environment. We encourage work/life balance, and we offer competitive wages and benefits.
The Medical Record Specialist is responsible for managing, processing, and fulfilling medical record requests received from third-party vendors, healthcare providers, auditors, government agencies, and other authorized entities. This role ensures timely, accurate, and HIPAA-compliant release of medical records to support reimbursement, audits, appeals, compliance reviews, and continuity of patient care.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Ans Receive, review, and process medical record requests from:
- Third-party vendors
- Insurance carriers
- Healthcare providers
- Internal departments
- Government agencies
- Recovery Audit Contractors (RAC)
- Commercial and Medicare auditors
- Validate request authenticity and authorization requirements prior to releasing records.
- Retrieve medical records from electronic health record (EHR), document management, and imaging systems.
- Compile, review, and submit complete and accurate medical documentation in response to:
- Medical record requests
- Audit requests
- Additional Documentation Requests (ADR)
- Pre-payment and post-payment audits
- Claims appeals and denials
- Monitor request status and ensure all submissions meet established turnaround time requirements.
- Maintain detailed logs and tracking reports of incoming and completed requests.
- Collaborate with providers, coding teams, billing departments, compliance teams, and payers to obtain missing documentation.
- Ensure compliance with HIPAA, CMS guidelines, state regulations, organizational policies, and release-of-information requirements.
- Research and resolve issues related to incomplete, duplicate, or denied record requests.
- Respond to provider inquiries regarding submitted requests and audit documentation.
- Maintain confidentiality and security of protected health information (PHI).
- Assist with process improvement initiatives to enhance productivity, compliance, and customer service.
KNOWLEDGE, SKILLS, ABILITIES:
- Ability to handle high call volumes and multitask effectively
- Proficiency in computer systems and electronic health records (EHR)
- Detail-oriented with strong organizational skills
- Strong knowledge of medical billing and coding practices
- Familiarity of ICD-10, CPT, HCPCS
- Strong Insurance Knowledge
- Must demonstrate strong analytical skills and proficiency with Microsoft office products
- Must have strong critical thinking skills
- Maintains effectiveness when experiencing major changes in work tasks or the work environment
- Ability to work independently without close supervision
- Ability to exercise judgement and make decisions
- Ability to perform in a high productivity, fast-paced environment
- Interpersonal skills and conflict resolution
- Attention to detail
- Excellent phone and computer skills
- Ability to maintain sensitive information in confidence
- Ability to meet deadlines and prioritize responsibilities
- Ability to train staff and write protocols and training materials
- Strong ability to uphold organizational values, work with integrity and ethically, inspire the trust of others, and treat people with respect
- Strong HIPAA and OSHA knowledge
EDUCATION / EXPERIENCE:
- High School or Equivalent
- Minimum of 1-3 years’ experience in medical billing preferred
WE OFFER:
- Medical Insurance, Dental, & Vision
- Health Savings Account
- Flex Spending for child care
- Paid life insurance of $50,000
- Paid Long Term Disability Insurance
- Voluntary Life Insurance
- Voluntary Short Term Disability
- Many Aflac Policies: Accident, Hospital, Critical Illness, Identity Theft, Legal Plan
- 401K – very generous plan… the company contributes even if you do not
- PTO (Paid Time Off) – generous plan
