Medical Records Specialist

Job description

Join BoldAge PACE and Make a Difference!
Why work with us?
• A People First Environment: We make what is important to those we serve important to us.
• Make an Impact: Enhance the quality of life for seniors.
• Professional Growth: Access to training and career development.

Competitive Compensation:
• Medical/Dental
• Generous Paid Time Off
• 401K with Match*
• Life Insurance
• Tuition Reimbursement
• Flexible Spending Account
• Employee Assistance Program

BE PART OF OUR MISSION!
Are you passionate about helping older adults live meaningful, independent lives at home with grace and dignity? BoldAge PACE is an all-inclusive program of care, personalized to meet the individual health and well-being needs of our participants. Our approach is simple: We listen to our participants and their caregivers to truly understand their needs and desires.
SUMMARY: The Medical Records Specialist is responsible for obtaining, managing, organizing, maintaining, and distributing participant medical records to support care coordination, compliance, service delivery, and operational needs across the organization.
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 Medical Records Specialist partners with providers, healthcare facilities, participants, caregivers, and internal stakeholders to ensure timely access to accurate and complete medical records.
The role may also perform Scheduling-related activities necessary to support participant services, continuity of care, and operational workflow needs. Accuracy, organization, customer service, attention to detail, and confidentiality are critical to success in this position.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Medical Records Operations
• 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.

Release of Information
• 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.

Scheduling & Operational Support
• 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.

Documentation & Compliance
• Maintain accurate records of medical records requests, retrieval activities, disclosures, and related documentation.
• Follow departmental workflows, policies, procedures, and documentation standards.
• 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.

Customer Service & Communication
• 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.

Continuous Improvement
• 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.

Other Duties
• 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.

KPI REQUIREMENTS (Key Performance Indicators)
To support departmental performance and participant service delivery, this role will maintain Key Performance Indicators (KPIs) related to:
• Medical records turnaround times
• Record retrieval completion rates
• Release of information compliance
• Documentation accuracy
• Productivity
• Customer service
• Compliance with department workflows and standards

Success in this role is demonstrated through:
• Timely retrieval and management of participant medical records.
• Accurate processing of records requests and disclosures.
• Consistent compliance with confidentiality, documentation, and regulatory requirements.
• Effective support of participant care coordination and operational workflows.
• Achievement of productivity and quality expectations.
• Positive contribution to participant, provider, and stakeholder satisfaction.
• Consistent support of departmental goals related to service, quality, compliance, and operational excellence.

EDUCATION AND EXPERIENCE:
• High school diploma or GED required.
• Minimum one year of experience in medical records, health information management, healthcare administration, referrals, authorizations, or related healthcare operations preferred.
• Experience in a PACE, managed care, ambulatory care, hospital, or healthcare environment preferred.
• Experience working with geriatric or frail elderly populations preferred.
• Experience coordinating appointments, services, or referrals preferred.

PRE-EMPLOYMENT REQUIREMENTS:
• 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.