HIM Audit Coordinator

Tufts Medicine•Lowell, MA

7d•$22 - $27•Onsite

About The Position

This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or deviation from standard procedures, and communicates information that requires some explanation or interpretation. The position is responsible for processing and managing medical record requests from payors, external auditors, and review agencies—including RAC, Blue Cross, and Permedion. Working under the general supervision of the HIM Manager of ROI and Document Management, this role ensures that all requests are handled accurately, efficiently, and in full compliance with HIPAA and all applicable facility, state, and federal regulations. The position uses Epic’s Release of Information (ROI) functionality to log, track, and process audit and review requests received via fax (Vyne/Trace), mail, or email. Based on chart type and request category, the coordinator determines whether requests should be routed to Sharecare or processed internally. For requests handled by HIM, the Coordinator retrieves required documentation from Epic and, when necessary, from third‑party EMRs such as Aria, Mosaic, or Restorix.

Requirements

High school diploma or equivalent
Two (2) years of office-related experience.
Proficiency with technology, office equipment, and the ability to learn various systems and software
Working knowledge of Microsoft office products (Outlook, Word, PowerPoint, Excel)
Strong computer literacy, including proficiency with word processing programs and spreadsheet applications and the ability to learn new systems.
Excellent customer service skills including strong interpersonal and telephone communication.
High degree of tact and professionalism when interacting with payors, internal staff from various departments, and internal HIM staff.
Accurate data entry skills with strong attention to detail.
Excellent organizational skills with the ability to prioritize tasks and adapt to changing work assignments.
Familiarity with medical terminology and basic coding concepts to understand documentation requirements.
Strong written communication skills for interacting with auditors and internal stakeholders.
Ability to work independently, exercise sound judgement, and manage time effectively.
Knowledge of HIPAA and relevant state and federal privacy regulations

Nice To Haves

Experience in EPIC EMR system
Experience performing Release of Information functions
Experience using digital imaging/scanning software and equipment

Responsibilities

Monitors, tracks, and completes requests for medical records from external auditors and reviewers; including, but not limited to RAC, Blue Cross, Permedion audits, etc.
Logs all requests into the EPIC/ ROI system, following established procedures, and updates the request upon completion.
Communicates with external auditors to ensure timely submission of required documentation.
Retrieves and compiles all required paper and electronic documents, including those needed from Ancillary departments. Export EMR content to a PDF and submit via secure record portals, secure fax/email, or on rare instances, will upload the PDF to an encrypted CD and send via FedEx
Prioritizes, organizes, and processes audits requests, coordinating with the Business Office (PFS) staff to identify documentation needed to substantiate claims.
Assists patients with medical record requests when needed, ensuring accurate guidance and adherence to HIPAA and privacy requirements.
Appropriately handles all records, in accordance with confidentiality policies and HIPAA requirements.
Performs quality review of documentation prior to submission of medical records -- ensuring completeness and accuracy before releasing.
Escalates compliance concerns to HIM leadership.
Maintains collaborative working relationships with peers, colleagues, and internal departments to support a positive and productive work environment.
Retrieves and distribute interdepartmental correspondence and mail to appropriate personnel.
Performs administrative tasks and other related duties as assigned.