The Release of Information (ROI) Specialist must ensure that every ROI is in compliance with the request, authorization, company policy, and federal (HIPAA) and state regulatory requirements. The ROI Specialist is responsible for processing level 1 low liability requestors including continuing care, durable medical equipment, government agency, adoption, coroner, state disability and military ROI requests in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. This position must provide exceptional customer service to patients/customers requesting a release of health information in situations that often require tight turnaround times, higher expectations and involve concerns with billing. The specialist must complete release of information requests including reviewing the patient's medical charts in Epic, identifying which information needs to be released, copying/scanning/e-delivery of medical records accurately and correctly, according to established procedures and standards of quality. The specialist is responsible for completing a 10 point verification process to help avoid breeches and possible legal actions.
1. Sort, prioritize, prepare, input and respond to all incoming documents via phone/fax/email/mail for ROI requests utilizing the ROI module in Epic.
2. Process requests for ROI in compliance with HIPAA and established protocols that when done correctly avoids the possibility of breech and legal action. Responsible for processing level 1 low liability requests for continuing care, durable medical equipment, government agency, adoption, coroner, state disability and military service ROI requests.
3. Retrieve records in response to requests for information while reviewing records for appropriate dates of service, verification of identity, and specific content requested. Might have to gather health information from multiple sources.
4. Communicate with attorneys, law enforcement, auditors, and insurance company representatives as well as a variety of other professionals regarding issues with payments, getting records, expediting requests and help getting authorizations as well as managing any complaints or concerns.
5. Interact with physicians and staff when requesting Visual Fields, OCT's and other test results that are not in EPIC from the eye department as well as Psych department and physicians when needing Psych approvals. Work with the disability and radiology departments as needed.
6. Provide patients assistance in completing authorization forms, guiding them on the process of ROI and completing their requests with high patient satisfaction.
7. In ROI module prepare invoices and collect payments for services provided. Review invoice sections of ROI to confirm appropriate billing or no charge before completing the request. Follow established protocols for receiving payment and processing through accounting.
8. Performs quality checks on all work to assure accuracy of the release, confidentiality and proper invoicing. Perform 3 step Quality Assurance (QA) by validating appropriate information on the authorization/request during intake, processing and completion. Must confirm patient identifiers, information to be released, time frame, requestor information and provide the" minimum necessary" is released in order to avoid breeches and possible legal actions.
9. Obtain guidance from the ROI Supervisor and Health Information Manager as needed.
10. Demonstrate helpful and effective telephone etiquette and customer service skills by providing appropriate information to callers. Ability to calmly deal with customers in stressful and escalating situations.
11. Performs other duties as assigned.
1. High school diploma or equivalent.
2. Minimum of 2 year office experience dealing with records management OR healthcare administration.
3. Experience working with confidential information, information security and use of ethical behavior when handling all information.
4. Basic computer and keyboarding skills. Proficient in the use of printers, scanners, fax machines and copy machines.
5. Exceptional customer service skills and ability to interact with patients/customers in stressful situations.
6. Experience working with confidential information, information security and use of ethical behavior when handling all information. Experience in a situation where consequence of oversight or error could result in financial or legal action.
7. Excellent communication skills, both verbal and written. Able to communicate effectively with providers, clinical staff, patients, insurance companies, lawyers, government agencies and various employers.
8. Demonstrated ability to multitask and feel comfortable with deadlines and changing priorities.
9. Demonstrated ability to work within clearly defined procedures with a moderate degree of supervision.
10. Strong attention to detail and critical thinking skills.
11. Problem solving skills including the ability to define problems, collect data, interpret data, facts, and draw conclusions.
12. Good interpersonal and teamwork skills.
1. Associates in a healthcare related field.
2. Experience working with confidential information.
3. Experience working in a position with stringent rules and procedures when processing information.
4. Knowledge of medical terminology.
5. Proficient in MS office applications.
6. Past work experience in customer service.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Ability to sit for extended periods.
2. Ability to see fine print and to use the computer for extended periods.
3. Ability to hear and converse on the phone and in person. Phone use is extensive.
4. Ability to perform fine motor tasks, such as computer, writing or phone tasks.
About SSM Health Dean Clinic-
Based in Madison, Wis., Dean Clinic consists of a network of more than 60 clinics in south-central Wisconsin. Our more than 500 physicians provide primary, specialty and tertiary care in the clinics as well as eye care through our Davis Duehr Dean locations. Dean Clinic also offers urgent care services and operates outpatient surgery centers. Dean Clinic joined SSM Health in 2013.