Job Overview

Our client is seeking a highly organized, detail-oriented, and proactive Medical Records & Authorization Coordinator to support medical records, billing records, CalOptima care coordination, post-hospital discharge, referral, and authorization workflows. The ideal candidate will have healthcare administrative experience and be comfortable working with medical records, insurance authorizations, EMR systems, Excel spreadsheets, email correspondence, and patient documentation. Experience with eClinicalWorks (eCW), CalOptima Health, Medi-Cal, medical/billing records requests, and insurance authorizations is preferred.

Schedule

• Monday - Friday, 8:30 AM - 5:00 PM PST with 1 hour unpaid break (40 work hours per week)

Responsibilities

Medical & Billing Records

• Manage medical and billing records requests from receipt through completion and release.
• Review requests and ensure all required information and documentation are available.
• Respond promptly and professionally to requesting parties by email regarding requests, fees, documentation, and status.
• Retrieve, organize, and prepare medical and billing records for release.
• Prepare and communicate applicable records-request fees.
• Track outstanding payments and follow up with requesting parties.
• Verify payment has been received before releasing records.
• Maintain accurate documentation of requests, communications, payments, and releases.
• Ensure records are securely released to the appropriate requesting party.
• Maintain confidentiality and follow HIPAA requirements.

CalOptima Care Coordination & Post-Hospital Discharge

• Assist with CalOptima Care Coordination Visits and post-hospital discharge follow-up.
• Review ER/hospital referrals and available discharge documentation.
• Prepare patient charts prior to scheduled care coordination visits.
• Ensure hospital records, diagnoses, medications, labs, imaging, and follow-up recommendations are available for the provider.
• Track scheduled, completed, canceled, no-show, and pending follow-up appointments.
• Follow up on patients who have not completed recommended follow-up.
• Maintain accurate documentation of care coordination activities.

Authorizations & Referrals

• Assist with submitting prior authorizations, referrals, and other insurance authorizations.
• Gather and submit required clinical documentation.
• Track authorizations from submission through determination.
• Follow up on pending, incomplete, or denied requests.
• Document authorization numbers, submission dates, status, determinations, and follow-up.
• Assist with corrections, resubmissions, and appeals when needed.

Excel & Tracking Logs

• Maintain accurate Excel spreadsheets and tracking logs for:
  • Medical and billing records requests
  • Records-request payments
  • CalOptima referrals
  • Post-hospital discharge patients
  • Care coordination visits
  • Authorizations and referrals
• Update logs promptly as information or status changes.
• Document communications, follow-up attempts, payments, authorization activity, and outcomes.
• Identify overdue or unresolved items and follow up appropriately.
• Assist with weekly or monthly reports as requested.

EMR & Communication

• Work within eClinicalWorks (eCW) or a similar EMR.
• Review and prepare patient charts and supporting documentation.
• Upload and organize documents in the appropriate patient chart.
• Communicate professionally with patients, requesting parties, insurance plans, hospitals, providers, and internal staff.
• Take ownership of assigned tasks and follow them through to completion.

Requirements

• MUST have at least 2 years of experience in medical records, billing records, authorizations, referrals, or care coordination.
• Experience handling medical records and confidential patient information.
• Experience using Microsoft Excel for tracking and documentation.
• Experience handling records requests, payment tracking, chart preparation, insurance authorizations, CalOptima care coordination, post-hospital discharge follow-up, Excel tracking logs, and EMR documentation.
• Strong written and verbal communication skills.
• Excellent organization and attention to detail.
• Strong follow-up and time-management skills.
• Ability to manage multiple tasks independently in a remote environment.
• Knowledge of HIPAA and patient confidentiality requirements.
• Reliable internet and an appropriate remote workspace.

Qualifications

• Experience with eClinicalWorks (eCW).
• Experience with CalOptima Health and Medi-Cal.
• Experience with post-ER or post-hospital discharge programs.
• Experience with care coordination or transitional care.
• Experience submitting insurance authorizations.
• Experience processing medical and billing records requests.
• Experience with payer portals such as Availity.
• Experience working in urgent care, primary care, medical groups, or outpatient healthcare.

What Our Client Is Looking For Our client is looking for someone who is dependable, responsive, organized, proactive, and able to work independently. The ideal candidate will take ownership of their assigned work and manage tasks from start to finish—including reviewing requests, communicating with the appropriate parties, obtaining missing information or payment, submitting authorizations, preparing charts, updating tracking logs, following up on outstanding items, and documenting completion. Our client is looking for someone who brings solutions, follows through, and does not require constant supervision.

Independent Contractor Perks

• Permanent work from home
• Immediate hiring
• Health Insurance Coverage for eligible locations

Note

Please click the "Apply" button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.

One application, multiple possibilities: When you apply, our team reviews your background against all current openings, not just this one! If a different role fits your skills, we'll get in touch! We also encourage you to keep exploring our job board and apply directly to any position that excites you.