The HIM Coordinator is responsible for organizing, maintaining, retrieving, and protecting participant health records. This role also manages participant referrals and authorizations, ensuring the accuracy, confidentiality, and integrity of medical records and the timely processing of referrals in compliance with Medicare/Medicaid regulations, HIPAA, and PACE requirements.
The coordinator supports the Interdisciplinary Team (IDT) to help ensure seamless care coordination and positive participant outcomes.
Key responsibilities include health information management, referral and authorization tracking, record retrieval, release of information processing, appointment coordination, and administrative support.
Health Information Management and Compliance
- Manage participant health records, including assembly, analysis, indexing, and filing of electronic and paper records.
- Ensure documentation is complete, timely, and properly maintained.
- Maintain confidentiality in accordance with HIPAA, state laws, and organizational policies.
- Conduct audits to ensure compliance with documentation and regulatory standards.
- Assist with accurate coding support for ICD-10, CPT, and related billing/encounter data.
- Maintain EHR data integrity and document referral status and communications.
- Process release of information requests in a timely and compliant manner.
- Retrieve consultation reports, imaging, and other records for review.
Referral and Authorization Management
- Serve as a point of contact for referrals, authorizations, and appointment scheduling.
- Prepare and process referrals accurately and on time.
- Track authorizations and follow up until issues are resolved.
- Manage re-authorization needs and submit retro-authorizations when required.
- Coordinate appointment details, transportation, and missed appointment follow-up.
- Complete surgery scheduling and related follow-up tasks.
- Communicate with participants, families, providers, and community resources.
- Verify Medi-Cal eligibility as needed.
Education and Experience
- Associate degree in health information management, health informatics, or a related field required; comparable experience may be considered.
- Two years of experience in health information management preferred, ideally in managed care, long-term care, or PACE.
- Experience with Medicare and Medicaid documentation, coding, and prior authorization rules is highly desirable.
Certifications
- RHIT preferred.
- RHIA or CCS preferred.
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago