Position is located in San Jose

Job Summary:

Performs duties required to fulfill and respond to most release of information requests ensuring accuracy and completeness; complies with federal and state privacy laws according to Kaiser Permanente policies and procedures. Using specialty software keeps track of requests so that they are delivered within compliant turnaround times. Collects fees and reconciles cash drawer if appropriate.

Essential Responsibilities:

+ Greet, counsel, and instruct patients and patients representatives on how to request medical information. Advise patients of processing requirements, estimated time for completion, provider responsibilities, and other factors affecting the request.

+ Identify appropriate release type from requests and complete or route as necessary. Recognize protected health information (PHI) requests that might lead to claims or actions against the organization and take appropriate action according to established policies and procedures.

+ Validate authorizations by consistently using the appropriate authorization checklists to ensure compliance with all applicable Kaiser Permanente policies and procedures and departmental guidelines. Process simple forms requests by abstracting appropriate documentation from the medical record onto the requested form according to department procedures. Save requested information to Adobe Professional, according to established policies and procedures and departmental guidelines, and burn CD or flash drive using software (if requested).

+ Log all appropriate requests in the Kaiser Permanente Health Connect-Release of Information tracking system and use detailed remarks in the comment field to track progress of request from beginning to end, based on department guidelines. Run daily incomplete reports to monitor and ensure compliant turnaround time. Copy all appropriate requests and follow department guidelines for scanning to medical record. Email, mail or fax completed forms per the preference of the requester or established guidelines. Close requests in tracking system per department guidelines.

+ Send requests to provider for approval/signature; in basket providers for approval to sign. Follow up with providers to ensure the return of requested information.

+ Interact with patients, third party requesters, physicians and insurance companies and provide education regarding release of information requirements according to Kaiser Permanente Guidelines. Clarify request and obtain additional authorization when needed. Answer phone to assist member with necessary information. Enter appropriate request information into tracking system based on phone request based on department guidelines.

+ Request charts and abstract data from charts or Kaiser Permanente Health Connect when necessary to complete miscellaneous forms, patient requests or comply with continuity of care and third-party requests.

+ Collect and record the appropriate fee from requesters, maintain the appropriate cash balance and reconcile the cash drawer at the end of the day if applicable.

+ Complete required annual training courses; apply knowledge learned and stay current on knowledge regarding Kaiser Permanente policies and procedures, federal and state privacy laws and compliance issues. Complete self assessment of release of information requests.

+ Review all work for completeness and/or signatures as may be required. Copy all requests and scan as appropriate. Contact patient for pick up and payment if appropriate

+ Perform other ROMI Specialist duties as assigned. Perform other duties as assigned.

Grade 04

Basic Qualifications:

Experience

+ Minimum one (1) year of general experience.

+ Per the National Agreement, current KP Coalition employees have this experience requirement waived.

Education

+ High School Diploma or GED.

License, Certification, Registration

+ N/A

Additional Requirements:

+ Alphanumeric data entry at 6000 key strokes/hour (equivalent to 24 words per minute).

+ Knowledge of medical terminology; must pass medical terminology test.

+ Must pass basic Microsoft Word skills test; must be competent with Adobe Acrobat Professional to combine, paginate, bookmark, redact, and password protect the medical record file within 90 days from date of hire.

+ Able to perform basic data analyses, make decisions and follow through within the parameters of job duties and within compliant turnaround times.

+ Must be service oriented with strong customer service skills and ability to communicate effectively.

+ Able to interact with the public effectively and with patience and professionalism while performing a wide range of clerical functions and activities.

+ Able to prioritize multiple tasks in a complex environment.

+ Able to work in a high-volume environment with frequent interruptions.

+ Able to work independently, organize and complete work with minimal supervision.

Preferred Qualifications:

+ One (1) year of general experience in a healthcare setting reading and understanding clinical and/or hospital health records preferred.

+ Knowledge of release of information laws (state and federal) preferred. Able to identify appropriate release type from requests preferred.

+ Working knowledge of Kaiser Permanente software systems such as Kaiser Permanente Health Connect preferred.

+ Working knowledge of Kaiser Permanente departments and functions preferred.

+ Some experience with cash handling, cash balance and cash reconciliation preferred.

COMPANY: KAISER

TITLE: Release of Medical Information Specialist I

LOCATION: San Jose, California

REQNUMBER: 1300506

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.