Medical Records Specialist

Medical Records Specialist

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.

QUALIFICATIONS:

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

Compensation details: 18-20 Hourly Wage

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