Description
Under indirect supervision, responsible for processing all Release of Information (ROI) requests in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. The ROI Assistant must at all times safeguard and protect the patient-s right to privacy by ensuring that only authorized individuals have access to the patient-s medical information and that all releases of information are in compliance with the request, authorization, company policy, State and Federal laws, and HIPAA regulations.
Essential Functions:
- NOTE: Specific positions may emphasize one or more of the following listed duties.
- Respond/triage in person, telephone and mail requests from members, outside agencies, clinics, insurance companies, attorneys, physicians and Kaiser Permanente staff regarding release of health record information.
- Release pertinent health care information through verbal and written communications in accordance with Regional Release of Information guidelines and Federal and State Laws.
- Assure proper authorization for disclosure by reviewing records for sensitive (HIV, Mental Health, Drug and Alcohol and Genetic) information, then comparing sensitive information with authorization to assure the authorization meets all necessary laws pertinent to the request.
- Utilize computer system applications and equipment to receive and dispatch information to requesting parties for both emergent and non-emergent situations.
- Analyze and prioritize incoming requests for release of information and code by type, i.e. coordination of care, disability forms, patient reviews, immunizations, attorneys and insurance companies.
- Prioritize incoming requests in order to meet turnaround time requirements of the release request.
- Create and update electronic health record (KPHC) disclosure database with pertinent information for tracking purposes.
- Abstract requested information from KPHC, Results Reporting, other information applications, and from the paper record for onsite member reviews.
- Assist members in all facets of onsite reviews to include: coordination of appointment, reviewing the record in preparation for the appointment; explanation of HIPAA amendment procedures and health medical record chart order and assisting members to place restrictions on disclosure of information.
- Communicate with the appropriate physicians regarding requested information for review.
- Coordinate, and complete amendment requests as per HIPAA guidelines.
- QA Invoices (check to make sure address and HR # are correct, etc.)
- Look up / create account number that payment will be posted to when received.
- Coordinate/track physician completion of forms and requests for narratives from attorneys, insurance companies, etc. May require communicating with the physician regarding completion.
- Assist with coordination of information for outside referrals by identifying appropriate information from KPHC, Results Reporting and the paper record per protocol and specific request and sending to the contract physicians.
- Coordinate the HIPAA mandated Disclosure Accounting process to include education and follow-up to KPNW staff.
- Reconcile QA and generate department billing, accept monies and route to cash control departments, and problem solve billing concerns.
- Perform other duties as assigned.
Basic Qualifications:
Experience
- One (1) year of experience in Medical Record File Service Department/ Hospital Medical Records or two (2) years of experience in a medically oriented office setting with heavy computer use, interaction with patients, insurance companies and clinicians or a recent graduate of an accredited Associate Degree Health Information Management (HIM) program.
- One (1) year customer service experience.
Education
- High School Diploma or GED.
License, Certification, Registration
- N/A.
Additional Requirements:
- Certification of medical terminology and abbreviations, current within two (2) years or final candidate(s) will need to complete the Kaiser Permanente medical terminology assessment with a minimum competency score of 84% or higher.
- Ability to type minimum 40 wpm with above average accuracy.
- Proficiency in the use of applicable computer software (e.g., MS Word, Excel, Outlook) and other work related tools (e.g., fax, copier, scanner, multi-line phone system, etc.).
- Strong organizational skills and ability to work independently and manage multiple priorities in a busy environment with frequent interruptions and time demands.
- Ability to effectively abstract computer or paper-based data with a strong attention to detail.
- Demonstrated courtesy, helpfulness and respect in dealing with customers.
- Good interpersonal skills with the ability to communicate effectively (both written and oral) with internal and external customers.
- Ability to calculate charges and balance cash receipts.
- Familiarity with terminal digit filing system.
- Willingness to work in a Labor/Management Partnership environment.
Preferred Qualifications:
- Two (2) years of recent experience with Protected Health Information (PHI) preferred.
- Experience with electronic medical record systems preferred.
- Excellent problem-solving, communication and negotiation skills preferred.
- Basic knowledge of Kaiser Permanente departments and functions preferred.
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