Upstream Rehabilitation is looking for a Medical Records Custodian to join our team!

Medical Records Custodian

Location Type: Birmingham, AL

On-Site

Build Your Career with Us!

Upstream Rehabilitation is the country’s largest dedicated provider of outpatient physical and occupational therapy services. Our mission is to inspire and empower the lives we touch, to serve our communities, and to lead with purpose-driven passion.

We are committed to delivering remarkable experiences and fostering an inclusive workplace where differences are valued and celebrated. With 1,200+ locations nationwide, 26 brand partners, and 8,000+ employees, Upstream operates at scale while leveraging data, technology, and innovation to drive smarter decisions and operational excellence across the organization.

The Role:

Join Upstream Rehabilitation, where your work makes a real impact! As a Medical Records Custodian, you will serve as the Company's designated Custodian of Records and be responsible for managing legal and certified medical records requests from receipt through closure. This includes records certifications and affidavits, court orders and subpoenas, legal holds, records that cannot be located in current systems, and requests escalated by Sales. In this role, you will be accountable for the accuracy, completeness, and defensibility of certified records and related documentation. You may be called upon to provide testimony in depositions or court proceedings regarding the Company's record-keeping practices and records management processes. This position requires working onsite at our Birmingham, Alabama office. As a key member of the team, you will help advance Upstream's mission, vision, and values while supporting the organization's continued growth and success.

What You’ll Do:

• Serve as the Company's designated Custodian of Records, certifying the authenticity and completeness of records produced by the organization.
• Prepare and sign records certifications and business records affidavits, coordinating notarization with the designated Notary Public.
• Respond to subpoenas and court orders in partnership with the Director of Compliance and the General Counsel's Office. Provide testimony regarding the Company's record-keeping practices when required.
• Own the legal hold queue, including removing duplicate requests, prioritizing work, and releasing held requests once cleared by Legal.
• Serve as the primary point of contact for legal, certified, and escalated records requests from receipt through documented closure.
• Manage requests escalated by Sales and Account Management through the established escalation process and provide timely status updates to stakeholders.
• Maintain and administer documented requirements for law firms with approved exceptions, including certification requirements and related documentation.
• Communicate professionally with attorneys and insurance representatives regarding request status, requirements, and records-related matters. Route relationship and account concerns to Sales or Account Management, as appropriate.
• Lead the resolution of requests in which records cannot be located, including conducting legacy system searches, account matching, and follow-up with requesters.
• Route identified chart errors, such as patient demographics or dates of service, through the appropriate correction and amendment processes.
• Track recurring errors and their sources, and report trends, case aging, turnaround times, and operational risks to the Manager of Medical Records.
• Release information only to authorized requesters and only as permitted by applicable authorizations, court orders, company policies, and HIPAA requirements.
• Escalate questionable, unusual, or high-risk requests to the Director of Compliance before releasing information.
• Other projects and duties as assigned.

Who You Are:

• High school diploma or equivalent required.
• Two or more years of experience managing healthcare records or processing Release of Information (ROI) requests.
• Experience handling legal ROI requests, including personal injury, motor vehicle accident, and workers' compensation matters.
• Proficiency in Microsoft Office applications, including Outlook, Word, and Excel.
• Strong attention to detail and commitment to accuracy.
• Working knowledge of HIPAA privacy regulations, state medical records requirements, records retention practices, and medical terminology.
• Demonstrated ability to manage high volumes of legal, insurance, and medical records documentation with a high degree of accuracy.
• Sound judgment in determining what information may be released under an authorization, request, subpoena, or court order, and when to escalate concerns to Compliance or Legal.
• Strong written communication skills, with the ability to communicate professionally with attorneys, insurance representatives, and internal stakeholders.
• Ability to remain composed and professional when responding to inquiries regarding records management and record-keeping practices.
• Strong analytical and problem-solving skills, including the ability to identify recurring errors, root causes, and process improvement opportunities.
• Experience working with electronic medical record (EMR) systems such as Raintree, WebPT, Net Health, Epic, or eClinicalWorks.

Nice to Haves:

• Associate's or bachelor's degree in Health Information Management (HIM), Healthcare Administration, or a related field.
• Experience processing release of information requests in an outpatient rehabilitation, physical therapy, orthopedic, or similar healthcare environment.
• Experience serving as, or working directly with, a Custodian of Records.
• Experience with Raintree.
• Registered Health Information Technician (RHIT), Certified Release of Information Specialist (CRIS), or similar healthcare information management certification.

Why You’ll Love Working Here

• The chance to directly shape our organization’s growth by hiring the talent that drives our mission.
• Opportunities to stretch your skills—whether you’re building pipelines, designing sourcing strategies, or advising leadership.
• A collaborative team environment where your ideas are valued.
• Competitive compensation, comprehensive benefits, and ongoing professional development.

Benefit Offerings:

• Annual paid Charity Day to give back to a cause meaningful to you
• 100% employer paid medical health insurance premium option available
• Dental and Vision insurance
• 401(k) with company match
• Generous PTO and paid holidays
• Supportive team and leadership invested in your success

A Better Place to Build Your Career

Upstream Rehabilitation offers meaningful opportunities across corporate and non-clinical roles, both remotely and in corporate offices nationwide. We invest in our people through leadership development programs, ongoing education, and professional growth opportunities.

Our corporate teams are critical to Upstream’s success—and to the culture that makes this a great place to work. You’ll join a group of talented professionals who collaborate, innovate, and know how to have fun while making a real impact.

Benefits and eligibility are dependent on employment status and pay class (full-time, part-time, or PRN). Specific details will be provided during the hiring process. 

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