Correspondence Technician in CHEROKEE, North Carolina at Cherokee Indian Hospital Authority

Primary Function

The incumbent is responsible for reviewing, verifying, and processing all requests for the release of medical information (ROI). They must have a comprehensive understanding of the legal and regulatory requirements associated with the release of protected health information (PHI). This knowledge ensures that health information is disclosed completely, accurately, and in compliance with established tribal, state, and federal regulations.

Job Description

• Receives and processed requests for PHI. Reviews requests for compliance to tribal, state, and federal requirements for release of information.
• Prepares correspondence to the requestor of PHI explaining requirements necessary for the authorization to be honored. Responds to authorizations within 10 days of receipt, selecting the abstracted information from the medical record in response to a wide variety of requests from various individuals, i.e. government and state agencies, insurance companies, medical facilities, etc.
• Analyzes the medical records according to regulatory requirements established by JCAHO and other accrediting agencies. Resolves any minor discrepancies and routes major discrepancies to the HIM manager. The analysis and evaluation for the record for responding to release authorizations will consist of quantitative analysis, qualitative analysis, and medico legal requirements.
• Quantitative Analysis – Comprehensive review to assure the presence of all component parts of the record, including correct identification and validation of each part by name, register number, dates, signatures, and the presence of all reports.
• Qualitative Analysis – Evaluation of the record for internal consistency and completeness.
• Medico legal requirement – Making the final determination that the record is complete, accurate, and reflects sufficient data to justify the diagnosis and warrant the treatment without infringing on physician clinical judgment.
• Responsible for maintaining a log of all requests for information on the RPMS Release of Information System and all information releases for accounting purposes as required by JCAHO and HIPAA.
• Acts as a technical resource for all personnel involved; ensures that all information complies with HIPAA regulations.
• Tracks and monitors all chart review audits to ensure compliance with medical record requirements.
• Provide support to management in conducting auditing and quality assurance activities.
• Performs other duties as assigned by the HIM Manager.

Job Knowledge

• Knowledge of the quantitative and qualitative analysis procedures.
• Extensive knowledge of the structure and physiology of major anatomical systems, the major disease process of each, and medical terminology.
• Extensive knowledge of medico legal requirements governing medical records and medical record reference (JCAHO, HIPAA, CMS, AMA).
• Knowledge of RPMS, EHR and Vista Imaging systems and knowledge in the collection and organization of data for statistical reporting.
• Excellent communication skills.
• Ability to work independently and collaboratively in a team environment.
• Proficiency in using office equipment and technology including Microsoft Office Suite
• Must be self-motivated, proactive, and able to work independently with minimal supervision.
• Must possess a valid North Carolina driver’s license.

Education/Experience

• Associate’s degree in Health Information Technology or a business field is required. Bachelor’s degree in Health Information Management or other related field is preferred.
• RHIA or RHIT is preferred.
• Six to eight months would be required to become proficient in all aspects of the job.
• The correspondence clerk must demonstrate component judgment in interpreting medical data in order to process release authorizations.
• Must be able to decipher illegible provider handwriting.

Contact with Others

Contacts are with patients, patient’s families, authorized representatives, facility employees, tribal offices, state and government agencies, hospitals, schools, legal representatives, and other representatives.

Contacts are made to coordinate work efforts to exchange or obtain patient medical information, solve technical problems, and participate in the finalization of medical records both legally and medical to maintain continuity of care.

Confidential Data

Has access to all departmental files, memos, financial records, and medical records, which are considered confidential. Must adhere to all HIPAA, Tribal, and Cherokee Indian Hospital Authority confidentiality policies and procedures in the performance of duties.

Responsibility for Accuracy

Medical records are an integral part of the operation of a medical facility. Health care entails regulated methods of recording, retrieving, and routing essential medical information on patient’s care.

Work must assure completeness, accuracy, and determination of records needed to, or from other facilities to promote continuity of care. As a representative of the hospital and responsible person for release of patient medical information, incumbent as well as hospital can be held liable for violation of state or federal laws for improper release of PHI.

Complexity of Duties

Close concentration and attention to detail are required while performing the job. The work is primarily sedentary, but requires some standing, walking, bending, carry of light items such as manuals or files, and work with equipment.

Supervision Received

Follows well-defined procedures and guidelines in job duties with minimal supervision. Judgment and initiative are required to maintain accuracy, efficiency, and to prioritize work and meet deadlines.

Environment

Work is performed in a medical record department setting. May require travel for training purposes.

Customer Service

Consistently demonstrates superior customer service skills to patients and customers. Ensure excellent customer service is provided to all patients/customers by seeking out opportunities to be of service.