Third-Party Liability & Medical Records Specialist

Job Summary: 

Genesis Orthopedics & Sports Medicine is seeking a detail-oriented Remote Third-Party Liability (TPL) & Medical Records Specialist to oversee lien and settlement tracking, ensure timely medical records processing, and proactively identify relevant cases from multiple platforms. This individual will play a crucial role in maximizing revenue recovery from third-party claims and maintaining compliance with HIPAA and other healthcare regulations—all while adhering to our remote work policies. 

Key Responsibilities: 

Third-Party Liability (TPL) & Lien Processing: 

• Identify new and existing TPL cases from multiple platforms (e.g., Epic EMR, insurance portals, legal request systems, and attorney communications). 

• Prepare, send, and track lien letters for personal injury, auto accident, and other third-party liability cases. 

• Monitor case status to ensure timely communication regarding settlements, dismissals, or claim denials. 

• Work directly with attorneys, insurance companies, and adjusters to obtain necessary updates on case progress. 

• Maintain accurate documentation and track outstanding TPL balances within Epic EMR. 

• Ensure compliance with federal, state, and payer-specific TPL billing rules. 

• Assist in coordinating subrogation claims and reimbursement requests from health insurance carriers. 

Medical Records 

• Process, track, and fulfill medical records requests from attorneys, insurers, government agencies, and patients. 

• Ensure requests are compliant with HIPAA, PHI privacy laws, and state medical records regulations. 

• Utilize Epic EMR to retrieve, review, and securely transmit medical records. 

• Identify relevant patient cases from multiple platforms to ensure all required records are processed accurately. 

• Handle subpoenaed records and coordinate responses to legal requests. 

• Maintain logs and tracking systems to ensure timely completion of requests. 

• Respond professionally to inquiries regarding record requests, fees, and processing timelines. 

Remote Work Requirements: 

• Must abide by Genesis Orthopedics & Sports Medicine's Remote Work Policy, which includes: 

• Uninterrupted access to high-speed internet and electricity during scheduled work hours. 

• A quiet, professional home office setup to maintain focus and confidentiality. 

• Compliance with HIPAA and PHI privacy standards while working remotely. 

• Responsiveness to email, phone, and Epic EMR communications throughout the workday. 

Qualifications & Skills: 

• Experience: 2+ years in medical records, revenue cycle, or TPL case management (orthopedics or personal injury experience preferred). 

• Technical Proficiency: Strong skills in Epic EMR, Microsoft Office (Excel, Word, Outlook), insurance portals, and email management. 

• Knowledge Base: Understanding of HIPAA, PHI, medical records processing, TPL/subrogation laws, and healthcare revenue cycle workflows. 

• Detail-Oriented: Ability to track multiple cases, deadlines, and requests with precision. 

• Communication: Strong written and verbal skills for engaging with law firms, insurance adjusters, and healthcare providers. 

• Problem-Solving: Ability to anticipate and resolve claim disputes or records compliance issues efficiently. 

Preferred Qualifications: 

• Experience in healthcare collections, personal injury claims, or legal billing. 

• Familiarity with lien processing, workers' compensation, and auto insurance billing. 

• Certification in Medical Records or Health Information Management (RHIT, CPC, etc.) is a plus.