Job Description
The HEALTH INFORMATION SPECIALIST position works under the direct supervision of the Director of Risk & Compliance and works closely with the Clinical Services and Quality Management (CSQM) team. The HEALTH INFORMATION SPECIALIST maintains the highest professional and ethical standards, interfacing with all company staff, patients, and stakeholders in a collegial manner. The HEALTH INFORMATION SPECIALIST is responsible for planning, coordinating, and administrating medical records requests in accordance with company rules and regulations, TJC, HIPAA, and all state statues of privileged information. The HEALTH INFORMATION SPECIALIST coordinates medical record requests including occasional collaboration with the Utilization Review (UR) and Legal department to ensure compliance. Additionally, this position assists the Clinical Services and Quality Management Team in all aspects within the scope of the department on staff trainings, policy development, process/system implementation, and utilization of best practices. The HEALTH INFORMATION SPECIALIST works closely with the Clinical Services & Quality Management (CSQM) leadership team to furnish reports and identifying trends for continuous quality improvement. This role provides recommendations to the Vice President of Clinical Services and Quality Management regarding the status of the clinical services and quality management components of all facilities, related training needs, identified action steps, and the status of progress and follow-up efforts.
HEALTH INFORMATION SPECIALIST RESPONSIBILITIES:
- Receives and processes medical records requests from physicians, insurance companies, attorneys, mental health providers, schools’ other facilities, families and state agencies.
- Ensures all company medical record protocol is in accordance with state, federal, and HIPPA regulations (45 CFR, 42 CFR Part 2).
- Tracks and monitors pending medical records requests and coordinates with Utilization Review (UR), contracting, and legal departments, as needed.
- Trains, troubleshoots, and assists facility staff with medical records protocols, measures, and forms via emails and phone calls.
- Responsible for auditing medical records requests and licensing processes to produce various reports.
- Compiles medical records requests and licensing data reports for monthly, quarterly, and annual internal review by leadership.
- Identify trends to assist in risk reduction and mitigation as well as maximize performance improvement for HIPAA compliance.
- Identify potential risks and escalates follow-up and/or investigation to appropriate leadership.
- Serves as a resource to the Clinical Services and Quality Management (CSQM) department providing day-to-day support for risk management, compliance initiatives, quality improvement, clinical documentation initiatives, meeting agendas and minutes, etc.
- Serves as a liaison between the Clinical Services and Quality Management (CSQM) Department and facility teams.
- Supports with additional risk, compliance, regulatory, and quality activities, as directed and needed.
- Completes tasks in a timely and accurate manner.
- Establishes and achieves realistic goals within the position.
- Attends designated meetings and/or conference calls.
- Maintains the confidential nature of resident and related activities.
- Performs other projects and duties as assigned.
STANDARD EXPECTATIONS:
- Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies/practices regarding confidentiality.
- Communicates clearly and effectively to the Clinical Services and Quality Management (CSQM) Team regarding person(s) receiving services and their family members, guests and other members of the health care team.
- Communicates clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team.
- Maintains the highest professional and ethical standards, interfacing with all company staff.
- Develops constructive and cooperative working relationships with others and maintains them over time.
- Encourages and builds mutual trust, respect and cooperation among team members.
- Maintains regular and predictable attendance and performance of job duties
- Knowledge of HIPAA regulation and procedures (required)