The Medical Records Specialist obtains, manages, organizes, maintains, and distributes participant medical records to support care coordination, compliance, service delivery, and operational needs. This role coordinates medical records requests, release of information activities, record retrieval, document management, and related administrative functions while ensuring compliance with organizational standards, HIPAA requirements, and applicable regulations. The specialist partners with providers, healthcare facilities, participants, caregivers, and internal stakeholders to ensure timely access to accurate and complete medical records.
Responsibilities
Receive, process, track, and complete medical records requests from internal and external stakeholders
Obtain medical records from hospitals, provider offices, specialists, facilities, and other healthcare organizations
Monitor and manage medical records work queues to ensure timely completion of assigned activities
Ensure records are received, indexed, uploaded, routed, and maintained in accordance with department procedures
Review records for completeness and appropriate documentation prior to processing
Organize and maintain electronic and paper records in accordance with established policies and procedures
Track pending requests and follow up as necessary to obtain required documentation
Support participant care coordination through timely retrieval and distribution of medical records
Maintain medical records according to retention and storage requirements
Process requests for release of information in accordance with applicable regulations and organizational policies
Verify appropriate authorizations, consents, and documentation requirements before releasing protected information
Prepare, distribute, and track medical records disclosures and requests
Ensure confidentiality and security of participant information at all times
Maintain accurate records of disclosures and release activities
Assist with scheduling-related activities necessary to support service delivery and participant care coordination
Support obtaining records required for appointments, authorizations, referrals, or care planning activities
Assist operational staff with locating and retrieving required documentation
Coordinate with Scheduling staff to ensure records are available to support upcoming participant services
Provide administrative support for operational workflows as assigned
Maintain accurate records of medical records requests, retrieval activities, disclosures, and related documentation
Follow departmental workflows, policies, procedures, and documentation standards
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1,000,000+
Tailored applications submitted
Comply with HIPAA requirements and all confidentiality standards
Support audit readiness through accurate documentation and record maintenance
Ensure compliance with applicable regulatory and organizational requirements
Provide professional and timely customer service to participants, caregivers, providers, healthcare facilities, and internal stakeholders
Respond to inquiries regarding records requests and documentation needs
Communicate effectively regarding record status, outstanding requests, and missing documentation
Escalate complex records requests, release of information concerns, and workflow barriers to the Senior Medical Records Specialist when appropriate
Support a positive participant and stakeholder experience through effective communication and timely follow-up
Identify workflow challenges and opportunities for process improvement
Participate in department initiatives related to quality, compliance, standardization, and operational performance
Support implementation of workflow improvements and operational changes
Participate in required training and educational activities
Participate in department meetings and organizational initiatives as assigned
Maintain confidentiality of participants, employees, and organizational information
Support departmental quality, compliance, and operational goals
Perform other duties as assigned
Requirements
High school diploma or GED required
Must have reliable transportation, a valid driver's license (if required to drive) or valid State issued ID, and the minimum state required liability auto insurance
Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact
Pass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen
Nice to have:
Minimum one year of experience in medical records, health information management, healthcare administration, referrals, authorizations, or related healthcare operations
Experience in a PACE, managed care, ambulatory care, hospital, or healthcare environment
Experience working with geriatric or frail elderly populations
Experience coordinating appointments, services, or referrals
Benefits
Medical/Dental insurance
Generous Paid Time Off
401K with Match
Life Insurance
Tuition Reimbursement
Flexible Spending Account
Employee Assistance Program
About the Company
BoldAge PACE is an all-inclusive program of care, personalized to meet the individual health and well-being needs of its participants. The company focuses on helping older adults live meaningful, independent lives at home with grace and dignity.
