Medical Records Specialist in Wakefield, MA at Parallon

Date Posted: 9/7/2018

Job Snapshot

Job Description

Retrieve, review, and redact medical records pertaining to Workman’s Compensation and Motor Vehicle Accident claims.  Follow HIPAA, insurance, and legal guidelines to ensure medical record requirements are met. Prepare bill package for printing and mailings medical claims for payer’s and clients.

Obtain medical records for processing, using Group Point, Hospital electronic medical records systems or paper copies. 

Analyzing and reviewing medical records for sensitive information that may require special authorizations for release.  This involves page by page review.

Redacting information that does not pertain to that particular visit in order to meet the minimum necessary standards.

Verifying that valid authorizations are on file when needed

Reviewing FACS system and the UB04 and/or HCFA has all information needed by the insurance company for the timely processing of payment.

Processing medical records and updating the FACS system with status changes.  Review step taken by claim representative.

Prepare medical records for billing by pulling in the appropriate bills and any other correspondence needed.

Printing and mailing paper claims where necessary.

Scanning medical records to the correct FACS accounts and updating status in FACS.

Process requests for medical records in a variety of ways:  printing directly from the client systems, create and distribute spreadsheets to clients and printing bills along with spreadsheets and mailing to medical records liaison on staff.  Create weekly and/or monthly reports on all outstanding medical records request to perform follow up with clients, liaisons, etc.

All other job duties as assigned by management

Duties may vary by Hospital or service center


Job Requirements

Ø  Education: High school diploma or equivalent.  Associate Degree, some College or technical school preferred.

Ø  Understanding/knowledge of medical coding or terminology

Ø  Knowledge:  Thorough knowledge of HIPAA and a familiarity with Workers Compensation and/ or Motor Vehicle insurance regulations or state law very helpful.  Understanding or experenance with medical billing procedures.

Ø  Experience:  One year experience in medical records and/or hospital billing. 

Ø  Skills: General computer and typing skills, ability to learn a variety of different computer systems and applications, good communication skills.  Demonstrated analytical and problem solving skills.  Extremely strong attention to minute detail.  Capacity to concentrate and focus for extended periods of time.


PHYSICAL DEMANDS/WORKING CONDITIONS – Requires sitting, some bending and reaching.  Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.  Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports.  Requires lifting papers or boxes up to 5 pounds occasionally.    Work is performed in an office environment.