Health Information Specialist

VieMed Careers•Lafayette, LA

About The Position

The Health Information Specialist will be responsible for reviewing and understanding insurance policies and standard Explanation of Benefits. This role involves effectively reviewing medical documentation, processing requests for medical records related to claims, and managing internal and external audits. The specialist will also monitor and maintain audit logs, perform internal audits for quality assurance, and manage patient medical records for insurance, private individuals, and government entities concerning home medical equipment. A key aspect of this role is establishing and maintaining effective communication with patients/families, physician offices, and internal teams to ensure patient benefit. Additional clerical tasks such as answering calls, faxing, and emailing are expected, along with clear communication to management and reporting of any concerns or issues to the Revenue Cycle Manager and Supervisor. Other responsibilities and projects may be assigned.

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

Minimum of 2 Years in DME experience required
3-5 Years in DME or medical billing experience preferred
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.
Handle Internal and external audits.
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.
Undertake other responsibilities and projects as assigned.