Health Information ROI Forms Specialist

Major Responsibilities:

• Ensures, safeguards and protects patients right to privacy by staying current and knowledgeable of all Federal and State Regulations and organization policies regarding privacy, confidentiality, and release of information.
• Receives and identifies the type of request for release of patient health information. Reviews and ascertains the correct patient and investigates questionable patient health information.
• Reviews all scanned documentation prior to release to ensure there are no “miss files” in the system.
• Validates and certifies requests for patient health information (PHI) ensuring they meet compliance standards and patient authorization. Contacts patients and/or employers to obtain appropriate authorizations.
• Reviews physician and clinical documentation in the patient medical record and transcribes the information onto the forms accurately and timely.
• Interprets, assigns and documents clinical information from the patient medical record related to the condition and diagnosis included on the forms requests.
• Ensures all releases of information are in compliance with the request, authorization, policies, and State and Federal/HIPAA regulations and guidelines. Collaborates with Risk and Legal Departments on government audit requests, complex court orders and other issues/requests as needed.
• Performs follow-up on all form completion requests to ensure patient satisfaction by meeting established key performance indicators.
• Scans/files patient information and documentation to the appropriate location of the health information record. Establishes and maintains effective working relationships with physicians and clinicians. Serves as a resource in answering patient, provider, and employee questions/concerns relating to requests for health information.
• May distribute, collect, and deposit fees/cash for forms completion, copies of medical information, and/or patient narratives, depositions and trial testimony. Process invoices accurately and timely for reimbursement for records processed and ensures prompt posting of revenue. Performs quality checks of scanned images to assure accuracy of the release, confidentiality, and proper invoicing, and makes corrections according to department policy. Performs clerical functions which may include: answering telephone calls, copying, faxing, completing/processing forms, documenting for care management, distributing mail, and/or ordering/delivering department or facility supplies.

Licensure, Registration, and/or Certification Required:

• None Required.

Education Required:

• High School Graduate.

Experience Required:

• Typically requires 2 years of experience in customer service, release of information, health information management or insurance underwriting within a healthcare environment. Ability to read and comprehend healthcare terminology, basic knowledge of human anatomy and disease processes.

Knowledge, Skills & Abilities Required:

• Excellent communication, interpersonal, customer service, and organizational skills.
• Excellent spelling, grammar and punctuation skills.
• Advanced computer skills including proficient keyboarding skills and experience in using Microsoft Office products, electronic mail and/or electronic health information records systems.
• Ability to work independently with minimal supervision and make decisions with good judgment.
• Demonstrated strong problem solving skills including the ability to handle difficult situations.
• Ability to prioritize workload, multi-task, and work under pressure in a fast-paced environment with time constraints.
• Knowledge and understanding of medical terminology and human anatomy and disease processes.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.