Health Information Management (HIM) Specialist

Job Overview

We are hiring a detail-oriented HIM Specialist to support healthcare operations through accurate and timely management of medical data and authorizations. This role requires prior experience in prior or retro authorizations, strong familiarity with clinical documentation and working knowledge of medical coding and billing processes. Ideal for candidates with a solid background in medical records and healthcare workflows.

Responsibilities

• Process and track prior and retro authorization requests
• Review clinical documentation to support authorization submissions
• Coordinate with healthcare providers to ensure all required information is accurate and complete
• Analyze patient records to confirm compliance with payer requirements
• Assist in resolving authorization denials or discrepancies
• Maintain organized and secure digital records
• Communicate with internal teams regarding status updates or missing documentation
• Follow HIPAA and data confidentiality guidelines at all times

Job Qualifications and Skills Set

• Prior experience in Prior or Retro Authorization (required)
• Familiarity with clinical terminology and medical record structures
• Experience with medical billing and/or coding preferred
• Strong attention to detail and accuracy in documentation
• Excellent communication and organizational skills
• Ability to interpret and apply healthcare payer policies
• Comfortable navigating EMR/EHR systems and medical data platforms