AdvancedHEALTH specializes in medical billing services, accounts receivable, and information management for medical practices. The Medical Records Specialist is responsible for managing, processing, and fulfilling medical record requests 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.
Key responsibilities include:
- 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 before releasing records
- Retrieve medical records from EHR, document management, and imaging systems
- Compile, review, and submit complete medical documentation in response to record requests, audit requests, Additional Documentation Requests (ADR), pre-payment and post-payment audits, and claims appeals and denials
- Monitor request status and ensure submissions meet turnaround time requirements
- Maintain logs and tracking reports for 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
Requirements & Qualifications
- High School diploma or equivalent
- 1-3 years of experience in medical billing preferred
- 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 skills
- 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 HIPAA and OSHA knowledge
Benefits & Perks
- Medical, dental, and vision insurance
- Health savings account
- Flexible spending for child care
- Paid life insurance of $50,000
- Paid long-term disability insurance
- Voluntary life insurance
- Voluntary short-term disability insurance
- Aflac policies available for accident, hospital, critical illness, identity theft, and legal plan coverage
- 401(k) with generous company contributions
- Paid time off (PTO)
Location
Tennessee, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago