Mass General Brigham · 10 hours ago
Release of Information Audit Abstractor
United States
Full-time
Remote
Entry Level
$21.78/hr - $31.08/hr
1+ years expMass General Brigham is a not-for-profit organization dedicated to advancing patient care, research, teaching, and community service. They are seeking a Release of Information Audit Abstractor responsible for abstracting protected health information and supporting various audits to ensure compliance and reimbursement. The role involves managing requests for medical records, ensuring timely fulfillment, and maintaining confidentiality according to established guidelines.
Health CareHome Health CareMedical
Responsibilities
Under the direction of the Audit Supervisor and according to established policies and procedures, the individual is responsible for accurately abstracting protected health information (PHI) by sorting, categorizing, searching, retrieving, and sending encounter documentation to support the Mass General Brigham reimbursement and/or compliance audits for services rendered
The Audit Abstractor is responsible for, including but not limited to, responding to third party payer requests, appeals, denials, QIO, Mass Health, RAC, CMS, ADR, HEDIS, Medicare Risk Adjustment, CERT, CDAC, DPH reporting, DRG, charge audits, joint venture audits, internal compliance audits, DME, Patient Financial Services (PFS), OIG, and/or third party payer audits
Fulfillment of such requests are performed on a timely basis ensuring that assigned due dates are met
Ability to prioritize competing tasks to ensure all due dates are met or exceeded
Accept ownership of assigned requests and worklists reaching out for clarification if necessary
Understands and enforces hospital confidentiality policies and procedures, department policies and procedures including Massachusetts General Laws (MGL), Federal Public Health Laws, HITECH, and HIPAA regulatory guidelines
Reviews requests to determine completeness and validity of authorization
Understands the rules governing the release of sensitive/protected PHI as pertaining to HIPAA, CFR 42 Part 2 rules, MA public health laws, MA mental health laws regulations, as well as, Mass General Brigham policies and procedures
Able to redact information when necessary
Maintains up-to-date knowledge of third party payer billing requirements to support services billed, including required medical documentation based on billing compliance rules
Locates medical record numbers and dates of service for encounters to be reviewed in system applications in response to requests
Produces computer-generated PHI from respective system applications including legacy applications
Coordinates electronic and paper record retrievals, trouble shoots for required records/documentation in response to a request and/or audit
Orders paper records as needed
Coordinates the retrieval of site specific applicable joint venture records required for an audit
Effectively utilizes Cobius, (emDR and esMD, including accessing requests, posting pdf’s, merging and delivering pdf’s), secure delivery server, e-fax, Adobe (searching, redacting, merging files, and securing security settings), portals, legacy applications, archived systems, and scanning documents
Acquires and maintains a strong working knowledge of the secure delivery server and e-fax functionality
Able to troubleshoot issues as needed
Examines records to be released and/or audited to ensure required and complete documentation is available to meet the requirements of a request
Works independently, as well as, contributes as a productive member of a team
Notifies the HIM Notes Deficiency if required documentation is missing for assistance
Troubleshooting may also require contacting appropriate providers/clinics to obtain required documentation
Prepares and delivers records to the designated review/audit location in a timely manner for onsite audits
Ensures 100% of requested records made available for an audit on time or provides expeditious mitigation to reconcile as needed
Photocopies paper records and/or prepares PDF’s for stat deliveries as needed
Prepares and coordinates the delivery of PHI via FedEx/UPS/US Mail, Cobius esMD, portal, e-fax, or secure delivery server to recipient as directed for offsite audits
Enters and fulfills all requests in logging system for tracking purposes
Meets performance measures/expectations
Other duties as assigned by the supervisor or manager
Qualification
Required
Ability to prioritize competing tasks to ensure all due dates are met or exceeded
Accept ownership of assigned requests and worklists reaching out for clarification if necessary
Understands and enforces hospital confidentiality policies and procedures, department policies and procedures including Massachusetts General Laws (MGL), Federal Public Health Laws, HITECH, and HIPAA regulatory guidelines
Reviews requests to determine completeness and validity of authorization. Understands the rules governing the release of sensitive/protected PHI as pertaining to HIPAA, CFR 42 Part 2 rules, MA public health laws, MA mental health laws regulations, as well as, Mass General Brigham policies and procedures. Able to redact information when necessary
Maintains up-to-date knowledge of third party payer billing requirements to support services billed, including required medical documentation based on billing compliance rules
Locates medical record numbers and dates of service for encounters to be reviewed in system applications in response to requests
Produces computer-generated PHI from respective system applications including legacy applications
Coordinates electronic and paper record retrievals, trouble shoots for required records/documentation in response to a request and/or audit
Orders paper records as needed
Coordinates the retrieval of site specific applicable joint venture records required for an audit
Effectively utilizes Cobius, (emDR and esMD, including accessing requests, posting pdf's, merging and delivering pdf's), secure delivery server, e-fax, Adobe (searching, redacting, merging files, and securing security settings), portals, legacy applications, archived systems, and scanning documents
Acquires and maintains a strong working knowledge of the secure delivery server and e-fax functionality. Able to troubleshoot issues as needed
Examines records to be released and/or audited to ensure required and complete documentation is available to meet the requirements of a request
Works independently, as well as, contributes as a productive member of a team
Notifies the HIM Notes Deficiency if required documentation is missing for assistance. Troubleshooting may also require contacting appropriate providers/clinics to obtain required documentation
Prepares and delivers records to the designated review/audit location in a timely manner for onsite audits
Ensures 100% of requested records made available for an audit on time or provides expeditious mitigation to reconcile as needed
Photocopies paper records and/or prepares PDF's for stat deliveries as needed
Prepares and coordinates the delivery of PHI via FedEx/UPS/US Mail, Cobius esMD, portal, e-fax, or secure delivery server to recipient as directed for offsite audits
Enters and fulfills all requests in logging system for tracking purposes
Meets performance measures/expectations
Other duties as assigned by the supervisor or manager
Associate degree or High school diploma or equivalent required
Understands the components of a medical record, including how a record is maintained, organized and the retrieval of medical documentation in both paper and/or electronic format
General understanding of reimbursement and billing compliance requirements
General knowledge of medical terminology
Self motivated and able to manage time effectively in a fast paced work environment
Medical Terminology
Strong computer skills
Proficient utilization in Microsoft Office products (Outlook, Teams, Word, PowerPoint, and Excel)
Exhibits critical thinking skills
Proficiency in the use of Adobe software
Ability to adapt to system enhancements and the onboarding of new site locations
Exhibits strong professionalism and highly proficient persona
Exhibits strong oral and written communication skills
Detail-Oriented
Excellent analytical and problem solving skills
Ability to be flexible, versatile, and adaptable in day to day activities conducted in a multi-site environment
Ability to manage workload and competing priorities in order to complete tasks within set limits
Ability to produce quality work on a consistent basis
Ability to work cooperatively and efficiently within all levels of the Mass General Brigham organization
Ability to work independently and as a team player
Demonstrates commitment to delivery of high quality customer service
Uses the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability and Service Commitment, Decisiveness, Innovation and Thoughtful Risk; and how we treat each other: Diversity and Inclusion, Integrity and Respect, Learning, Continuous Improvement and Personal Growth, Teamwork and Collaboration
Preferred
Experience working in the Health Information Management field; minimum of 1-2 years experience preferred
General knowledge of HIPAA privacy and security rules and state and federal rules and regulations related to the disclosure of protected health information preferred
Experience working with Epic clinical and/or financial applications preferred
Benefits
Comprehensive benefits
Career advancement opportunities
Differentials
Premiums and bonuses
Recognition programs designed to celebrate your contributions and support your professional growth
Company
Mass General Brigham
Mass General Brigham specializes in providing medical treatments and health diagnostics services.
10001+ employees
H1B Sponsorship
Mass General Brigham has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
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2025 (77)
2024 (61)
2023 (93)
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2021 (80)
2020 (29)
Funding
Current Stage
Late StageLeadership Team
E
Erin Flanigan
SVP, Human Resources, Community, Specialty Hospital Division
O’Neil A. Britton
Chief Integration Officer, Executive Vice President
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