Health Plan Request Bench Release of Information Specialist II

Summary of Position

The Health Plan Request (HPR) Bench Release of Information Specialist (ROIS) II processes release of information (ROI) requests related to health plan audits with accuracy, efficiency, and compliance across multiple client accounts. This role requires a high level of proficiency in various electronic medical record (EMR) systems, adherence to HIPAA regulations and uphold strict confidentiality standards. The HPR Bench ROIS III independently prioritizes tasks, troubleshoots requests, and collaborates effectively with internal teams while adapting to evolving workflows and compliance requirements, as well as ensuring they can fulfill all client-specific onboarding and access requirements.

Duties & Responsibilities

• Process medical ROI requests related to health plan audits quickly and accurately, ensuring compliance with HIPAA and client requirements
• Utilize Verisma software applications to input, manage, and track medical records
• Organize and retrieve records within multiple EMR systems, ensuring all documentation is properly structured and complete
• Interpret medical records, forms, and authorizations to correspond to specific audit measures
• Maintain high standards of production, efficiency, and accuracy meeting company standards and performance metrics
• Prioritize workload effectively and work independently while meeting productivity goals
• Communicate effectively within the HPR team and in a cross-functional manner, as necessary
• Attain a solid understanding of client-specific expectations across multiple accounts while ensuring compliance with HIPAA, HITECH, state regulations, and company policies
• Utilize Verisma’s reference materials and compliance guidelines to maintain confidentiality and accuracy in all tasks
• Assist with training and mentoring new associates, as needed, ensuring knowledge transfer and consistency in processes
• Attend and actively participate in training sessions, workflow updates and team meetings, as required
• Maintain all necessary background checks, drug screenings, health screenings and access requirements to serve on the Bench
• Perform other related duties, as assigned, to support the effective operation of the department and the company
• Live by and promote Verisma Core Values

Minimum Qualifications

• High school diploma or equivalent required; some college preferred
• RHIT certification preferred
• 3+ years of experience in medical records, Release of Information (ROI), or Health Information Management (HIM), with expertise in supporting multiple clients and processing audit requests
• Knowledge of HIPAA and state regulations related to the release of protected health information
• Must be able to maintain all necessary background checks, drug screenings, health screenings and access requirements to serve on the Bench
• Clerical or office experience with data entry, document management and proficiency in using general office equipment
• Proficient in Microsoft Office Suite and multiple EMR systems, with the ability to troubleshoot and adapt to new technologies
• Strong problem-solving, organizational and time management skills with keen attention to detail
• Strong ability to work independently while meeting high productivity expectations
• Ability to effectively multi-task or change projects, as needed
• Prior remote experience, preferred

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without prior notice.