About Circadia Health
Circadia Health is a growth-stage healthcare AI company on a mission to prevent avoidable hospitalizations and transform senior-care operations. Our Circadia Intelligence Platform combines:
-
Contactless sensing that monitors respiration and motion with medical-grade accuracy
-
Native predictive models that detect 85% of preventable adverse events several days in advance
-
Enterprise integrations that operationalize predictions directly inside EHR, care-coordination, billing, and compliance workflows
Today, our technology touches 40,000+ post-acute patients daily across skilled-nursing, home-health, and home-care networks. We are backed by leading healthcare and AI investors and headquartered in El Segundo, CA.
About the Role
As Circadia's Provider Ops Specialist, you'll work directly with our Provider Operations team to manage the full lifecycle of incoming medical records requests, coordinating closely with the RCM team as needed. You'll be the person who logs, tracks, prepares, and reviews these requests to make sure the right documentation goes out accurately and on time.
This role is based out of our headquarters in El Segundo, CA.
What You'll Do
- Log and track all incoming medical records requests across payer portals, fax, mail, and email, maintaining accurate records of deadlines, reference numbers, and status.
- Prepare and consolidate required documentation into complete, organized packets for each request.
- Review packets for accuracy, including patient identity, dates, and completeness, prior to submission.
- Submit completed packets to the requesting payer or entity through the appropriate channel and confirm receipt when required.
- Identify and escalate missing, inconsistent, or questionable documentation before it impacts a submission.
- Collaborate with the Revenue Cycle Management (RCM) team and Physician Operations to source claims, billing, and provider documentation needed for audit responses.
- Maintain and update the request tracking log, escalating at-risk deadlines proactively.
- Maintain organized digital recordkeeping to support compliance and audit readiness.
How Success is Measured (KPIs)
- Submission packets are accurate and complete, with no cross-patient or documentation errors, prior to submission.
- Zero missed payer deadlines across the active caseload.
- Documentation gaps or inconsistencies are identified and flagged internally prior to submission.
- The request tracking log remains current and accurate at all times.
Must-Have Qualifications
- Minimum 2 years of experience in a high-paced medical office setting, managing incoming medical records requests and compiling clinical documentation.
- Working knowledge of medical records workflows, HIPAA requirements, and release-of-information processes.
- Experience working with EHR systems.
- High attention to detail, with the ability to accurately cross-reference dates, patient identifiers, and documentation across multiple sources.
- Strong organizational skills, with the ability to coordinate multiple requests and deadlines simultaneously without losing track of status or priority.
- Comfortable learning and adapting to new software tools and digital filing systems.
- Strong written and verbal communication skills.
- Ability to thrive in a dynamic, evolving startup environment.
Nice-to-Haves
- Experience with payer audits, ADRs, SIU requests, or Medicare Risk Adjustment/HCC documentation.
- Familiarity with remote patient monitoring (RPM/RTM) billing and CPT coding basics.
- Experience working in or with skilled nursing facilities (SNFs).
- Experience with esMD, Kiteworks, or other secure health information exchange portals.
- Proficient with PDF tools, spreadsheets, and document assembly software.
Circadia Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by law.
