[Remote] Release of Information Audit Abstractor

Note: The job is a remote job and is open to candidates in USA. Mass 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.ResponsibilitiesUnder 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 renderedThe 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 auditsFulfillment of such requests are performed on a timely basis ensuring that assigned due dates are metAbility to prioritize competing tasks to ensure all due dates are met or exceededAccept ownership of assigned requests and worklists reaching out for clarification if necessaryUnderstands and enforces hospital confidentiality policies and procedures, department policies and procedures including Massachusetts General Laws (MGL), Federal Public Health Laws, HITECH, and HIPAA regulatory guidelinesReviews requests to determine completeness and validity of authorizationUnderstands 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 proceduresAble to redact information when necessaryMaintains up-to-date knowledge of third party payer billing requirements to support services billed, including required medical documentation based on billing compliance rulesLocates medical record numbers and dates of service for encounters to be reviewed in system applications in response to requestsProduces computer-generated PHI from respective system applications including legacy applicationsCoordinates electronic and paper record retrievals, trouble shoots for required records/documentation in response to a request and/or auditOrders paper records as neededCoordinates the retrieval of site specific applicable joint venture records required for an auditEffectively 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 documentsAcquires and maintains a strong working knowledge of the secure delivery server and e-fax functionalityAble to troubleshoot issues as neededExamines records to be released and/or audited to ensure required and complete documentation is available to meet the requirements of a requestWorks independently, as well as, contributes as a productive member of a teamNotifies the HIM Notes Deficiency if required documentation is missing for assistanceTroubleshooting may also require contacting appropriate providers/clinics to obtain required documentationPrepares and delivers records to the designated review/audit location in a timely manner for onsite auditsEnsures 100% of requested records made available for an audit on time or provides expeditious mitigation to reconcile as neededPhotocopies paper records and/or prepares PDF’s for stat deliveries as neededPrepares 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 auditsEnters and fulfills all requests in logging system for tracking purposesMeets performance measures/expectationsOther duties as assigned by the supervisor or managerSkillsAbility to prioritize competing tasks to ensure all due dates are met or exceededAccept ownership of assigned requests and worklists reaching out for clarification if necessaryUnderstands and enforces hospital confidentiality policies and procedures, department policies and procedures including Massachusetts General Laws (MGL), Federal Public Health Laws, HITECH, and HIPAA regulatory guidelinesReviews 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 necessaryMaintains up-to-date knowledge of third party payer billing requirements to support services billed, including required medical documentation based on billing compliance rulesLocates medical record numbers and dates of service for encounters to be reviewed in system applications in response to requestsProduces computer-generated PHI from respective system applications including legacy applicationsCoordinates electronic and paper record retrievals, trouble shoots for required records/documentation in response to a request and/or auditOrders paper records as neededCoordinates the retrieval of site specific applicable joint venture records required for an auditEffectively 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 documentsAcquires and maintains a strong working knowledge of the secure delivery server and e-fax functionality. Able to troubleshoot issues as neededExamines records to be released and/or audited to ensure required and complete documentation is available to meet the requirements of a requestWorks independently, as well as, contributes as a productive member of a teamNotifies the HIM Notes Deficiency if required documentation is missing for assistance. Troubleshooting may also require contacting appropriate providers/clinics to obtain required documentationPrepares and delivers records to the designated review/audit location in a timely manner for onsite auditsEnsures 100% of requested records made available for an audit on time or provides expeditious mitigation to reconcile as neededPhotocopies paper records and/or prepares PDF's for stat deliveries as neededPrepares 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 auditsEnters and fulfills all requests in logging system for tracking purposesMeets performance measures/expectationsOther duties as assigned by the supervisor or managerAssociate degree or High school diploma or equivalent requiredUnderstands 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 formatGeneral understanding of reimbursement and billing compliance requirementsGeneral knowledge of medical terminologySelf motivated and able to manage time effectively in a fast paced work environmentMedical TerminologyStrong computer skillsProficient utilization in Microsoft Office products (Outlook, Teams, Word, PowerPoint, and Excel)Exhibits critical thinking skillsProficiency in the use of Adobe softwareAbility to adapt to system enhancements and the onboarding of new site locationsExhibits strong professionalism and highly proficient personaExhibits strong oral and written communication skillsDetail-OrientedExcellent analytical and problem solving skillsAbility to be flexible, versatile, and adaptable in day to day activities conducted in a multi-site environmentAbility to manage workload and competing priorities in order to complete tasks within set limitsAbility to produce quality work on a consistent basisAbility to work cooperatively and efficiently within all levels of the Mass General Brigham organizationAbility to work independently and as a team playerDemonstrates commitment to delivery of high quality customer serviceUses 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 CollaborationExperience working in the Health Information Management field; minimum of 1-2 years experience preferredGeneral knowledge of HIPAA privacy and security rules and state and federal rules and regulations related to the disclosure of protected health information preferredExperience working with Epic clinical and/or financial applications preferredBenefitsComprehensive benefitsCareer advancement opportunitiesDifferentialsPremiums and bonusesRecognition programs designed to celebrate your contributions and support your professional growthCompany OverviewMass General Brigham specializes in providing medical treatments and health diagnostics services. It was founded in 1994, and is headquartered in Somerville, Massachusetts, USA, with a workforce of 10001+ employees. Its website is https://www.massgeneralbrigham.org.Company H1B SponsorshipMass General Brigham has a track record of offering H1B sponsorships, with 77 in 2025, 61 in 2024, 93 in 2023, 70 in 2022, 80 in 2021, 29 in 2020. Please note that this does not guarantee sponsorship for this specific role.



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