Medical Records Reviewer

Revenue Cycle Management is looking for a full-time Medical Records Reviewer to join our team!

SUMMARY: The Medical Records Reviewer is responsible for performing specialized review of complex medical and billing records requests and documentation to ensure accurate, complete, and appropriately supported records production. The Reviewer reviews records packages, affidavits, subpoenas, and Depositions on Written Questions (DWQs), resolves documentation discrepancies, performs first-level quality assurance, and maintains thorough knowledge of established recordkeeping, retrieval, retention, and release procedures.

ESSENTIAL FUNCTIONS:

• Review complex medical and billing records requests, subpoenas, DWQs, and affidavit requests for completeness, scope, authorization, and processing requirements; escalate unresolved disclosure or legal questions.
• Ensure retrieved medical records and itemized billing statements correspond to the correct patient, encounter, and date of service and are complete, legible, and consistent with maintained source records. Review medical and billing affidavits and supporting documentation for factual accuracy and completeness in accordance with established procedures.
• Support the accurate preparation and processing of subpoena and DWQ responses within assigned responsibilities and established procedures.
• Identify and resolve missing, inconsistent, duplicate, or mis-indexed documentation, coordinating corrections with appropriate personnel without altering underlying clinical or billing documentation.
• Perform first-level quality assurance reviews of records packages prepared by Medical Records Coordinators, documents corrections and confirms release readiness.
• Maintain thorough knowledge of how medical and billing records are created, maintained, retrieved, retained, and released within assigned systems and entities.
• When authorized, accurately explain established records management and release procedures in written, verbal, or formal inquiries, within the scope of actual knowledge.
• Handle complex inquiries from attorneys and other authorized parties, documenting communications, commitments, and resolution steps.
• Monitor assigned request deadlines, corrections, follow-up items, and exceptions through completion, promptly communicate risks or delays to Lead.
• Provide on the job guidance to Medical Records Coordinators on documentation quality, records handling, and established workflows.
• Protect confidential information, follow HIPAA and organizational procedures, escalate requests requiring specialized authorization or interpretation, and immediately report suspected privacy incidents or misdirected releases in accordance with policy.
• Maintain established accuracy, productivity, and turnaround standards.
• Perform other related tasks as needed.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Thorough knowledge of medical and billing records management, documentation review, document integrity, recordkeeping systems, and release-of-information workflows.
• Knowledge of affidavit, subpoena, and DWQ processing requirements and established escalation procedures.
• Ability to review complex records objectively, identify discrepancies, determine required corrections, and communicate factual findings accurately.
• Ability to explain established documentation, retrieval, retention, and release procedures within the scope of assigned responsibilities and actual knowledge.
• Strong critical thinking, independent judgment, attention to detail, organization, deadline management, and problem-solving skills.
• Strong written and verbal communication skills, including the ability to communicate professionally with attorneys and other authorized parties.
• Proficiency with electronic medical record (EMR), billing, document management, and request tracking systems.
• Knowledge of HIPAA, confidentiality requirements, and organizational procedures governing protected health information.

EDUCATION AND EXPERIENCE:

• High School Diploma or GED
• Two (2) years of experience in medical records, health information management, or revenue cycle
• Experience reviewing record requests, affidavits, subpoenas, or DWQs

BENEFITS:

• 3 Medical Plans
• 2 Dental Plans
• 2 Vision Plans
• Employee Assistant Program
• Short- and Long-Term Disability Insurance
• Accidental Death & Dismemberment Plan
• 401(k) with a 2-year vesting
• PTO + Holidays

Please visit our website for more information:

Premier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career, and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Employment with Premier Medical Resources is contingent on the successful completion of a pre-employment drug screen and background check.