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.
Position descriptions are not intended to be and should not be construed to be a complete list of all the duties and responsibilities performed by incumbents. Duties, responsibilities and expectations may be added, deleted or modified at any time at the discretion of the supervisor.
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.
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your fa...mily and our community live long, healthy lives.
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