Medical records specialist & audit clerk

Position Summary:

The Medical Record Specialist & Audit Clerk is responsible for maintaining and reviewing medical records for completeness, accuracy, and compliance with regulatory standards and processing requests for medical records in accordance with HIPAA and privacy regulations. This role responds to payer audits with the correct medical records and supporting documentation including verifying coding and billing accuracy to support reimbursement requirements.

Essentials Duties and Responsibilities:

• Maintain medical records in compliance with HIPAA and other regulatory standards.
• Review medical records for completeness, accuracy, and compliance.
• Process requests for medical records in accordance with privacy rules.
• Process audits from payers in accordance with payer policies and health insurance provisions.
• Ensure timely retrieval and submission of medical records to patients, providers, attorneys, government agencies, insurance companies, and payers.
• Track and resolve documentation deficiencies.
• Monitor adherence to healthcare regulations, accreditation standards, and organizational policies.
• Respond to inquiries regarding medical records and audits.
• Support quality improvement initiates related to documentation and record management.
• Assist with internal and external compliance audits.
• Assist with denials or recoupments based on medical record deficiencies or medical necessity.
• Collaborate with managers and administrative staff to resolve record discrepancies.

Qualifications:

Education

• High School diploma or GED required.
• Associate degree in Health Information Management, Medical Office Administration, Healthcare Administration, or related field preferred.
• RHIT certification preferred.

Experience

• 3-5 years’ experience in medical records, health information management, auditing, release of information, or healthcare administration.
• Experience with MS Office and Electronic Health Records (EHR) systems required.

Knowledge, Skills, and Abilities

• Knowledge of HIPAA, medical terminology, and healthcare documentation standards.
• Familiarity with healthcare auditing procedures and compliance requirements.
• Strong attention to detail and analytical skills.
• Proficiency with Microsoft Office and EHR software.
• Excellent organizational, written communication, and time management skills.
• Ability to maintain confidentiality and handle sensitive information.
• Ability to work in a team environment and collaborate effectively.
• Ability to work independently in a remote environment.

Monday to Friday
8am to 5pm CST or EST