The Health Information Specialist organizes and maintains patient medical and behavioral health information and records. They assist providers and patients with submitting and completely referrals to external providers and organization. They are responsible for insurance and patient billing activities of the organization. In addition, they perform a variety of record keeping and clerical duties in support of health center services.
Essential Functions as Health Information Specialist
§ Generate and prepare/assemble medical records in a complete, accurate and organized manor.
§ Scanning of all medical documents including registrations.
§ Organize medical records for accuracy.
§ Obtain medical information from ER visits, hospital discharges, etc as indicated.
§ Complete medical release requests that include all the required information from insurance companies, lawyers, and other appropriate agencies..
§ Record release request and bill appropriate parties for records requests in accordance with HFHC policies.
§ Route records to appropriate personnel or department.
§ Prepare charts as requested for special audits and peer review.
§ Maintain all records and health information Confidentiality following all laws and regulation including HIPPA and HFHC policies.
§ Destroy records per HFHC policy.
§ Consult supervisor, appropriate staff, and resources to resolve health information questions.
§ Track referrals from the time created by provider to the time that results are received.
§ Coordinate with external providers and organizations to submit referral along with all required documents.
§ Ensure referrals are sent to the external provider, organizations, and location preferred by the patient
§ Communicate with providers, when needed, to ensure correct tests are ordered based on ICD and CPT coding
§ Obtain prior authorizations from insurance companies when required
§ Close referrals once results are received
§ Follow up with patients and external providers and organizations on outstanding referrals.
§ Document in EHR systems all actions and steps taken on the referral
§ Create claims from the EHR systems sending bills to insurance companies, both private and government (Maine Care, Medicaid, Medicare, Workers Compensation) via paper and/or electronic means.
§ Interface with insurance companies through their portals to verify coverage and to correct billing issues.
§ Review all claims for accuracy of ICD-10 and CPT codes.
§ Maintain all patient accounts with the electronic (EHR) billing system via codes meant to facilitate reimbursement from commercial and government insurance groups.
§ Monitor billing errors and work with staff to correct any EHR data issues that affect billing.
§ Research, correct, and re-submit rejected and denied claims to include appeals when necessary.
§ Bill patients for the portion of fees they are responsible for, to include both self-pay patients and those that have been assigned patient responsibility by their insurance.
§ Answer patient questions regarding statement.
§ Track and post all payments and adjustment from both insurance companies and into the EHR systems.
§ Perform bad debt collection activities through to account resolution, including communication to patients, clients and other external entities while adhering to all HFHC, state and federal guidelines.
§ Review sliding fee applications and enter into the EHR systems.
§ Maintain regular communications and coordination with patients until such time that the accounts are paid.
§ Establish patient payment plans as needed.
§ Serves as collection point for outgoing mail.
§ Back up front desk/patient reception as needed.
§ Prepare reports and forms as directed and in accordance with established policies.
§ Communicate with providers, support staff and HFHC departments professionally and respectfully at all times.
§ Participates in all required staff, education and supervisory meetings.
§ Provide excellent customer service to all internal and external customers.
§ Other duties as assigned by the CFO.
§ Knowledge of chart controls including, access and storage of records to maintain in accordance with established policies and regulations.
§ Knowledge of medical records regulations and release of health information.
§ Ability to use computers and computer software including MS Word, Excel and Power Point and EHR.
§ Excellent communication skills
§ Excellent organizational skills
§ Ability to work effectively and professionally as part of a team
§ High School diploma or GED equivalent.
§ Two to three years of relevant experience preferred.
Job Types: Part-time, Full-time
Pay: $16.00 - $19.00 per hour
- Dental insurance
- Employee assistance program
- Health insurance
- Paid time off
- Vision insurance
- 8 hour shift
- Monday to Friday
Covid-19 Vaccine Required.
Work Location: In person