HIM Audit Coordinator

Tufts Corporate; Lowell (MA); On-site; USD 29,000 - 37,000; Full time

Job summary

Tufts Medicine is seeking a HIM ROI Coordinator to manage medical record requests in a secure, HIPAA-compliant manner. The role uses EPIC ROI to log and track submissions and coordinates with auditors.

Strong attention to detail and confidentiality are essential for handling sensitive patient information. Responsibilities include interfacing with external auditors, preparing documentation, and ensuring timely responses while maintaining collaboration with the Healthcare Information Management

Qualifications

• High school diploma or equivalent
• Two (2) years of office-related experience.

Responsibilities

• Process medical record requests from payors and auditors.
• Log requests in EPIC/ROI system and update status.
• Communicate with external auditors for timely documentation.
• Retrieve and compile required documents from departments; export to PDF and submit securely.
• Prioritize and process audit requests with PFS staff.
• Assist patients with medical record requests per HIPAA.
• Handle records with confidentiality.
• Quality review of documentation before submission.
• Escalate compliance concerns to HIM leadership.
• Collaborate with peers and internal departments.
• Distribute interdepartmental mail.
• Perform administrative duties as assigned.

Skills

Tech literacy

Customer service

Communication

Organization

HIPAA knowledge

Data entry

Education

High school diploma or equivalent

Tools

EPIC EMR

ROI software

Imaging software

Job description

Hours: 40 hours per week; M-F from 8:00 AM to 4:30 PM

Location: Onsite at Lowell General Hospital - Main Campus. Hybrid schedule may be available at the discretion of your manager after training.

Job Profile Summary

This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following 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.

Job Overview

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 thirdparty EMRs such as Aria, Mosaic, or Restorix.

Job Description

Minimum Qualifications

• 1. High school diploma or equivalent
• 2. Two (2) years of office-related experience.

Preferred Qualifications

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

Duties and Responsibilities

The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

• 1. Monitors, tracks, and completes requests for medical records from external auditors and reviewers; including, but not limited to RAC, Blue Cross, Permedion audits, etc.
• 2. Logs all requests into the EPIC/ ROI system, following established procedures, and updates the request upon completion.
• 3. Communicates with external auditors to ensure timely submission of required documentation.
• 4. 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
• 5. Prioritizes, organizes, and processes audits requests, coordinating with the Business Office (PFS) staff to identify documentation needed to substantiate claims.
• 6. Assists patients with medical record requests when needed, ensuring accurate guidance and adherence to HIPAA and privacy requirements.
• 7. Appropriately handles all records, in accordance with confidentiality policies and HIPAA requirements.
• 8. Performs quality review of documentation prior to submission of medical records -- ensuring completeness and accuracy before releasing.
• 9. Escalates compliance concerns to HIM leadership.
• 10. Maintains collaborative working relationships with peers, colleagues, and internal departments to support a positive and productive work environment.
• 11. Retrieves and distribute interdepartmental correspondence and mail to appropriate personnel.
• 12. Performs administrative tasks and other related duties as assigned.

Physical Requirements

• 1. Work is performed in a professional office environment with standard office equipment such as computers, phones, photocopiers, and filing cabinets.
• 2. Primarily a sedentary role, which involves sitting most of the time, but does involve movements such as walking, standing, reaching, ascending / descending stairs and operate office equipment.
• 3. Frequently required to speak, hear, communicate and exchange information.
• 4. Able to see and read computers displays, read fine print, and/or normal type size print and distinguish letters, numbers and symbols.
• 5. Occasionally lift and/or move up to 25 pounds.

Skills & Abilities

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

At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day.

The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals.

Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth-one of the many ways we invest in you so you can thrive both at work and outside of it.

Pay Range

$21.53 - $26.91

based on full-time equivalent