Medical Records Specialist

Pedes Orange County; Irvine (CA); On-site; USD 50,000 - 65,000; Full time

Job summary

Pedes Orange County in Irvine, CA seeks a Medical Records Specialist to manage incoming requests, ensure HIPAA compliance, and coordinate with providers, payors, and patients.

The role serves as the primary contact for faxed records, calls, and authorizations, maintaining accurate records and supporting the Health Information Management team in a fast-paced, regulatory environment.

Qualifications

• Must have knowledge of HIPAA and privacy rules.
• Experience with health information management processes.
• Familiarity with electronic health record (EHR) systems.
• Ability to manage inbound records requests and communications.
• Strong organizational and documentation skills.
• Ability to handle confidential information professionally.

Responsibilities

• Process inbound faxes and records requests daily.
• Log and track requests with status updates.
• Ensure HIPAA-compliant releases and accuracy of documentation.
• Respond to calls with guidance on records process.
• Coordinate with providers, payors, attorneys, and patients as needed.
• Maintain logs and identify process gaps; support team training.

Skills

HIPAA compliance

Records management

Communication skills

Attention to detail

Telephone & fax handling

Privacy & confidentiality

Education

High school diploma or equivalent

Associate's degree in Health Information Technology

Tools

EHR systems

Fax management platforms

Job description

Job Title: Medical Records Specialist

Department: Health Information Management

Reports To: Practice Manager

Status: Full-Time | Non-Exempt

Position Summary

The Medical Records Specialist is responsible for the comprehensive management of incoming medical records requests and related communications. This role serves as the primary point of contact for all inbound faxes, records requests, and phone inquiries, while ensuring all records releases comply with HIPAA regulations, organizational policies, and applicable federal and state laws. The specialist works closely with management to support payor and legal records requests, and collaborates with provider offices and patients to obtain all necessary authorizations prior to release.

Key Responsibilities

Inbound Fax & Records Request Management

• Monitor and process all inbound faxes on a daily basis, triaging and routing accordingly
• Review and log all inbound records requests, verifying completeness and legitimacy before processing
• Ensure all requests are tracked in the records management system with accurate status updates
• Meet established turnaround time standards for records fulfillment

Inbound Call Management

• Answer and manage inbound calls from patients, provider offices, insurance companies, attorneys, and other authorized parties requesting medical records
• Provide professional, accurate guidance on the records request process, required documentation, and expected timelines
• Escalate complex or sensitive inquiries to management as appropriate

Authorization & Compliance

• Verify that all required authorizations, consents, and clearances are obtained prior to releasing any patient records
• Ensure all releases comply with HIPAA Privacy Rules, 42 CFR Part 2 (where applicable), and state-specific regulations
• Identify and flag any incomplete, expired, or deficient authorizations and follow up to resolve

Payor & Legal Request Support

• Assist management in fulfilling records requests from insurance payors, including pre-authorization reviews, audits, and claims-related requests
• Support the processing of legal requests including subpoenas, attorney requests, and court orders under the direction of management
• Maintain accurate documentation of all payor and legal requests and their dispositions

Provider & Patient Communication

• Communicate professionally with external provider offices to coordinate records exchanges and ensure proper documentation is in place
• Contact patients as needed to explain the authorization process, obtain signatures, and answer questions regarding their records
• Serve as a liaison between internal departments and external parties to facilitate timely and compliant records fulfillment

General Duties

• Maintain organized and accurate records logs, tracking all requests from receipt through completion
• Identify process gaps and communicate recommendations to management
• Support cross-training and coverage within the Health Information Management team as needed

Qualifications

• High school diploma or equivalent required; Associate's degree in Health Information Technology or related field preferred
• Minimum 1–2 years of experience in medical records, health information management, or a related healthcare administrative role
• Working knowledge of HIPAA regulations and medical records release requirements
• Familiarity with electronic health record (EHR) systems and fax management platforms
• Strong organizational skills with the ability to manage high volumes of requests accurately
• Excellent verbal and written communication skills
• Ability to handle sensitive and confidential information with professionalism and discretion