Under minimal supervision, the HIM ROI Specialist will be responsible for coordinating centralized requests for release of information for all areas within Billings Clinic where records are maintained (i.e., hospital and clinic records, radiology, lab systems, etc.). Responsibilities include review of all written and verbal requests for release of information to ensure the validity of the request and the authorization to release the requested information comply and adhere with all regulatory requirements and guidelines and Billings Clinic policies and procedures.


Essential Job Functions


• Supports and models behaviors consistent with Billings Clinic's mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
• Acts as the centralized review point for receipt of all requests for release of information from both the hospital and clinic medical records. Evaluates authorizations to ensure they meet all eight (8) criteria required by HIPAA and the state of Montana. Evaluates requests that do not require an authorization to ensure Billings Clinic can disclose the information without an authorization through review of HIPAA, Montana law, and Billings Clinic policies.
• Accepts and signs for subpoenas and/or court orders; performs initial review to determine if all criteria (HIPAA and Montana law) are met and confers with Manager, Director or General Counsel for final approval to process.
• Responds to questions of patients and/or staff regarding appropriate disclosures, researches legal and regulatory guidelines in questionable situations, facilitates request and receipt of protected health information (PHI) from other facilities for Billings Clinic.
• Identifies presence and/or location of medical records by reviewing CIS, Medic, AS400 or documentation of other medical record locations (includes branch clinics, inactive records in storage, shadow chart locations, PHI that Billings Clinic maintains previously belonging to other practitioners, and microfilm). Coordinates with and/or forwards request for release of information to the appropriate areas for copying of the appropriate records to provide integrated response to request. Ensures that complete medical record is obtained and copied when such is requested or in response to subpoena or court order.
• Log requests in ROI (Release of Information) software identifying requestor, patient, information requested, date needed, ensuring compliance with regulatory and legal requirements.
• Reviews all copies of health care information prior to disclosure of records to the requestor to ensure:
only the requested materials have been released
authorization matches healthcare information copied
records have been obtained from Radiology, Patient Accounts, and any other site housing PHI that has been authorized to be disclosed
information is delivered to the appropriate individual or requestor based upon the authorization, subpoena or court order
• Acts as a resource and provides support to HIM Specialists and release of information staff by handling customer complaints, resolving issues, identifying request priorities and assigning requests to be processed. Responsible to train HIM Specialists to read authorizations and obtain appropriate information from the medical record.
• Receives copies from various areas and compares each page to the original medical record to ensure complete information requested is provided prior to certifying affidavit or records are delivered for subpoenas or court orders.
• Invoices each request to ensure appropriate charges are made for copies; processes checks received in department by crediting invoice in software; and documenting monies received and forwarding to HIM Administrative Assistant.
• Maintains or exceeds 95% accuracy based on audit findings. Maintains or exceeds 90% department productivity standards for assigned tasks
• Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements.
• Maintains competency in all organizational, departmental and outside agency safety standards relevant to job performance.
• Performs other duties as assigned or needed to meet the needs of the department/organization.