Under general supervision and reporting to the Manager of HIM, the Senior HIM Processor is responsible for processing release of medical information requests, review of charts for physician incomplete and missing documents according to Hospital Policy and Medical Staff Bylaws and Rules and Regulations, processing medical records, performing analysis on medical records and providing excellent customer service for requests.
* Handle refusal message center inbox.
* Run weekly deficiency report and send out emails.
* Run daily report and flag providers for deficiencies.
Release of Information
* Performs release of information (ROI) to all requesters according to policy and HIPAA Laws.
* Process patient walk in requests daily.
* Process Fax folder requests daily.
* Process Legal requests.
*Process insurance requests.
* Process all “incomplete” requests in Request Management.
* Use Request Management as your working queue – check daily.
* First Level Requests. Workflow will be all DRG, prepayment review, anything to do with the possibility of the claim being denied. Log these requests into MIDAS after vetting if additional documentation is needed from clinic visits, etc. This will be noted in the comments in MIDAS application.
* Monitor ROI email.
* Logging and scanning requests (In house requests/ShareCare requests)
Staff development
* Participates in new hire training and Department orientation under the supervision of the Manager.
Data Integrity
* Demonstrates and maintains patient confidentiality to protect the patient.
* Remains knowledgeable of imaging standards, policies and procedures and HIPAA regulations to work in compliance of these and other standards.
Compliance/Safety
* Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
* Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility
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* If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.
* Completes all company mandatory modules and required job-specific training in the specified time frame.
Education |
Experience |
CALL REQUIRED: Must be able to physically show up |
No |
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