ROI Specialist

INSIGHT Surgical Hospital•Coldwater, MI

7d•Onsite

About The Position

The ROI Specialist responds to subpoenas according to Insight Hospital and Medical Center policies within the prescribed period of time. This role serves as a Release of Information (ROI) subject matter expert, performing complex duties including processing requests for Protected Health Information (PHI). The specialist determines the validity of authorizations, requests, and documentation provided from various entities such as patients, doctors, hospitals, Workers’ Compensation, insurance companies, and legal entities. This position acts as a direct link to the Risk Management and Legal departments, responding to legal actions involving Insight Hospital and Medical Center medical records by processing subpoenas and court orders within required time frames. The ROI Specialist also serves as a resource to customers regarding release of information laws, ensuring proper authorization and legal documents are obtained before fulfilling requests. All medical record requests must be processed within seven business days, with exceptions for records prior to the hospital's inception, which are forwarded to Vital Records/VRC. The role verifies the identity of requesters to ensure patient health information remains confidential, timely, accurate, and follows established policies with strict adherence to HIPAA. Additionally, the specialist helps establish and maintain policies and procedures for the department's health portal, enabling patient access to their records at any time, and maintains a record of all released records for regular storage and auditing.

Requirements

Processing requests for Protected Health Information (PHI).
Determining validity of authorization, request and documentation provided from patients, doctors, hospitals, Workers’ Compensation, insurance companies and legal entities (i.e. subpoena, subpoena documents, power of attorney, deposition and affidavits).
Responding to subpoenas and court orders within required time frames.
Ensuring proper authorization and legal documents are obtained prior to completion of all requests.
Processing all medical record requests within seven business days.
Verifying the identity of requests to ensure requests for patient health information are confidential, timely, accurate and follow established policies with strict adherence to HIPAA.
Maintaining policies and procedures for the department’s health portal.
Keeping a record of all records released in an ongoing file to be stored and audited on a regular basis.

Responsibilities

Responds to subpoenas according to Insight Hospital and Medical Center policies, within the prescribed period of time.
Processes requests for Protected Health Information (PHI).
Determines validity of authorization, request and documentation provided from patients, doctors, hospitals, Workers’ Compensation, insurance companies and legal entities (i.e. subpoena, subpoena documents, power of attorney, deposition and affidavits).
Serves as a direct link to the Risk Management and Legal departments.
Responds to any legal action involving Insight Hospital and Medical Center medical records by processing subpoenas and court orders within required time frames.
Acts as resource to customers regarding release of information laws while ensuring proper authorization and legal documents are obtained prior to completion of all requests.
Ensures all requests for all medical record requests are processed within seven business days.
Verifies the identity of requests to ensure requests for patient health information are confidential timely, accurate and follow established policies with strict adherence to HIPAA.
Helps establish and maintain policies and procedures for the department’s health portal so that they may access their records at any time.
Keeps a record of all records released in an ongoing file to be stored and audited on a regular basis.
Other duties as assigned.