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Whether from an authorized representative or from a patient, a medical abstractor will locate and retrieve information from appropriate medical records and prepare that data for presentation to the requester. Expert knowledge of medical terminology and an intimate familiarity with medical procedures are central to the job and are applied in four main areas: processing requests, extracting information, process improvement, and tracking related billing. In addition, a keen eye for detail is required in order to fulfill such requests accurately and in accordance with established organization procedures and legal requirements. Employees or contractors working in such a position will put to use strong organization skills and multitasking capabilities on a daily basis. Also, he or she may have to occasionally deal with an irrational requestor, in addition to handling stressful conditions effectively.
Prioritizing and processing information requests are two tasks performed regularly by a medical abstractor. This requires using the information obtained from the requestor and comparing that information with corresponding medical records to ensure accuracy and established priority. Using established organizational processes and procedures, he or she will determine the priority of requests and make sure the relevant details and signatures required accompany the request, and in emergency situations process the request without delay. Additionally, he or she may contact patients and/or authorized representatives upon discovery of any issues associated with the received request immediately, in order to expedite the process.
Extracting the required information to fulfill the request is the central part of the medical abstractor’s job. During this process, he or she may access medical data from a variety of sources to include both digital media and physical hard copies. After pulling and verifying the required information, the medical abstractor will usually document the request, often in an online database for tracking purposes. Part of this process may include preparing invoices for requests requiring payment.
Documenting the fulfillment of the request is also required and usually serves two purposes: to prove proper procedures for legal purposes and to ensure an efficient process. Quality control is central to this reporting process with the objective of identifying opportunities for improvement and/or compliance. Outlining the required resources and communicating those findings to both authorities and internal auditors helps to facilitate the realization of recommended improvements.
Billing and collecting payment from a requestor may also be part of the job description for a medical abstractor. Responding to delays or neglect of payment, he or she may also send written reminders and communicate verbal reminders regarding payment due. Providing a requestor with accepted payment methods and working to secure that payment is sometimes part of the medical abstractor’s duty.