Medical Records & Authorizations Specialist

We are seeking a highly organized and detail-oriented Medical Records & Authorizations Specialist to support healthcare operations by managing medical records processing insurance authorizations and ensuring compliance with regulatory and privacy standards in a fully remote environment. The successful candidate will play a critical role in facilitating patient care and reimbursement by maintaining accurate documentation and coordinating authorization processes efficiently.

This position is strictly limited to candidates who currently reside in the United States and are legally authorized to work in the U.S. Applications from individuals residing outside the United States will not be considered.

Key Responsibilities:

Request retrieve review and maintain patient medical records in accordance with HIPAA regulations

Process prior authorizations referrals and pre-certifications with insurance carriers

Verify insurance eligibility coverage requirements and authorization criteria

Communicate with healthcare providers insurance companies and patients regarding authorization status

Ensure accuracy completeness and confidentiality of medical documentation

Update electronic medical records (EMR/EHR) systems with authorization and record information

Track authorization approvals denials and expirations; follow up as needed

Prepare and maintain reports related to medical records and authorization activity

Support audits compliance reviews and quality assurance initiatives

Required Qualifications:

High school diploma or equivalent; Associates or Bachelors degree in Health Information Management Healthcare Administration or related field preferred

Minimum of 24 years of experience in medical records management insurance authorizations or healthcare administration

Strong knowledge of HIPAA medical terminology and healthcare documentation standards

Experience working with EMR/EHR systems and insurance portals

Excellent organizational communication and time-management skills

High attention to detail and ability to manage multiple priorities remotely

Proficiency in Microsoft Office Suite and healthcare information systems

Preferred Qualifications:

Certified Professional in Healthcare Information and Management Systems (CPHIMS) RHIT or similar certification

Experience in physician practice hospital or outpatient clinical settings

Familiarity with Medicare Medicaid and commercial insurance authorization processes

Compensation:

Annual Salary Range: $45000 $65000 USD commensurate with experience certifications and geographic location

Benefits:

Comprehensive medical dental and vision insurance

401(k) retirement plan with employer matching

Paid time off sick leave and paid holidays

Life short-term and long-term disability insurance

Remote work flexibility

Professional development and certification reimbursement

Employee assistance and wellness programs

Work Authorization & Residency Requirement

Must be legally authorized to work in the United States

Must currently reside within the United States

Applications from candidates residing outside the U.S. will be automatically rejected.