Responsible for the processing of requests for medical records for all areas in the CBO and communicating with the Affiliate HIM Release of Information (ROI) Departments for the requests to be completed in a timely manner. Responsible for the retrieval and distribution of health information for financial purposes (when needed to get a bill paid) for initial billing for designated payers as appropriate. Also responsible for assisting the Clinical Appeal Specialist and the Denial Appeal Specialist in the gathering and mailing of all documents related to appeals. Maintain confidentiality of protected health information according to HIPAA regulations, with ability to identify records/information afforded special confidentiality under law. Identifies opportunities for process improvement including, but not limited to, additional training needs.
Processes large volume of paper bills needing medical records attached.
Responds to requests for medical information regarding designated payers.
Will be the point person for ROI requests from the entire CBO.
Assures receipt of a properly completed ROI request form.
Communicates effectively with Affiliate HIM ROI Departments regarding ROI requests.
Handle requests maintaining patient confidentiality.
Prints all letters and documents for appeals as directed by the Clinical Appeal Specialists and the Denial Appeal Specialists.
Works requests daily to ensure completed appeals are submitted for payment in a timely manner.
Ensures documents are faxed/mailed by certified mail to the appropriate addresses as designated by the Clinical Appeal Specialists and the Denial Appeal Specialists on a daily basis.
Ensures all certified mail receipts are logged into EPIC and scanned into OnBase
Completes daily work lists, special projects and monthly reports as assigned.
Must be knowledgeable about HIPAA, state and federal regulations governing disclosure of PHI including HIV/AIDS and behavioral health information.
Must work independently and have the ability to make decisions relative to individual work activities.
Strong attention to detail and ability to multi-task.
Performs effectively in a high volume work environment and able to meet deadlines.
Maintain regular and consistent attendance at work.
Adhere to all UnityPoint Health Personnel policies and procedures and Safety guidelines.
Behave in a manner consistent with all Corporate Compliance policies and procedures.
Will actively participate in the ROI Sub-Committee of the HIM Affinity Group in the absence of the supervisor and/or Manager.
Will escalate any questions or issues to Supervisor for resolution in a timely manner.
Participates in departmental and interdepartmental meetings as appropriate.
Perform other duties as assigned.
Working knowledge of medical terminology.
Knowledgeable of computer and software applications.
Adaptability and flexibility in moving between various functions based upon staffing and/or workload demands.
Ability to establish/maintain effective working relationships.
Must be detail oriented and organized to deal with multiple priorities.
Comprehension of oral/written instructions.
Ability to work as a team member and collaboratively accomplish goals.
Ability to perform functions under the stress of conflicting demands and deadlines without allowing activities to become disorganized.
Willing to accept additional assignments.
Coordinates work to achieve maximum productivity and efficiency with little supervision.
Prior experience in hospital registration, health information management, physician office, or medical billing and knowledge of industry terminology is highly preferred.
Ability to analyze data, perform multiple tasks and work independently.
Ability to think critically and make decisions appropriately.
Ability to learn and master multiple computer systems.
Requires highly developed communication skills to effectively work with all levels of management throughout the UnityPoint Health, its subsidiaries and affiliates.
Possesses excellent written and verbal communications.
Ability to work as a team member, creating and maintaining effective working relationships.
Ability to understand and apply guidelines, policies and procedures.
High school diploma or equivalent