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, encourage work/life balance, and 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
- Receive, review, and process medical record requests from third-party vendors, insurance carriers, healthcare providers, internal departments, government agencies, Recovery Audit Contractors (RAC), and 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, and 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 with ICD-10, CPT, and HCPCS.
- Strong insurance knowledge.
- Strong analytical skills and proficiency with Microsoft Office products.
- Strong critical thinking skills.
- Ability to work independently without close supervision.
- Ability to exercise judgment and make decisions.
- Ability to perform in a high-productivity, fast-paced environment.
- Strong interpersonal skills and conflict resolution abilities.
- 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 understanding of HIPAA and OSHA requirements.
Education and experience
- High school diploma or equivalent.
- Minimum of 1-3 years of experience in medical billing preferred.
Benefits
- Medical insurance, dental, and vision
- Health Savings Account (HSA)
- Flexible spending for child care
- Paid life insurance of $50,000
- Paid long-term disability insurance
- Voluntary life insurance
- Voluntary short-term disability
- Aflac policies, including accident, hospital, critical illness, identity theft, and legal plan options
- 401(k) with company contribution
- Generous paid time off (PTO)
Location
Tennessee, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago