Health Information Specialist

VieMed Healthcare•Lafayette, LA

About The Position

The Health Information Specialist will be responsible for managing patient medical records for insurance, private individuals, and/or government entities related to home medical equipment. This role involves reviewing insurance policies, medical documentation, and resolving requests for medical records for claims processing, audits, and authorized external entities. The specialist will also maintain audit logs, perform internal quality assurance audits, and establish effective communication with patients, physicians' offices, and internal teams. Additionally, the role includes performing clerical tasks such as answering calls, faxing, and emailing, and reporting concerns to the Manager/Supervisor and Revenue Cycle Manager.

Requirements

High School Diploma or equivalent
Knowledge of Explanation of Benefits from insurance companies
Working knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid
Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
Knowledge of policies and procedures to accurately answer questions from internal and external customers.
Utilizes initiative while maintaining set levels of productivity with consistent accuracy.

Nice To Haves

Superior organizational skills.
Proficient in Microsoft Office, including Outlook, Word, and Excel.
Attention to detail and accuracy.
Effective/professional communication skills (written and oral).

Responsibilities

Review and understand Insurance policies and standard Explanation of Benefits.
Review and understand medical documentation effectively.
Review and resolve requests for medical records related to claims processing, internal and external audits, and authorized external entities.
Monitor & maintain audit logs.
Perform internal audits for quality assurance.
Manage medical records of patients for insurance, private individuals and/or Government entities for home medical equipment.
Establish and maintain effective communication and good working relationships with patients/family, physicians’ offices, and other internal teams for the patient’s benefit.
Perform other clerical tasks as needed, such as answering patient/Insurance calls, faxing and Emails.
Communicate appropriately and clearly to Manager/Supervisor, and other superiors. Report all concerns or issues directly to Revenue Cycle Manager and Supervisor.
Perform other responsibilities and projects as assigned.