Associate, Member Experience

To be responsible for the seamless, daily operations of the front office of the Health Information Management Department at our Medical Office Buildings by responding to basic, simple and quick health information and member experience inquires and requests and to provide a high quality member experience. Escalates more complex inquires and request to the appropriate departments.

Health Information Management

• Ensures that all protected health information is processed in accordance with regional, national, state and federal regulations.
• Works closely with internal/external customers to meet their health information management needs as it relates to release of protective health information via paper and electronic media.
• Has a solid knowledge/understanding of HIPPA privacy and security issues as it relates to release of information, and/or other regulations related to protective health information.
• Reviews release requests for appropriateness and validate the authorization by photo identification.
• Serves as inter and intra department resource for the other staff members, answering questions and providing instructions as necessary.
• Monitors printers for incoming documentation and process paper work in a timely manner.
• Collects loose filing/scan documents from clinical area twice daily, ensuring that a medical record number is placed on each document.
• Opens departmental mail and sorts; forwards mail appropriately to document preparation station or other clinical units, as necessary.
• Verifies patient identity and process same day Release of Information Request via KP HealthConnect EMR.
• Requests patient charts by accessing the appropriate system.
• Responds to inquiries from patients and staff members and instructs them in the appropriate methods for requesting records. Enters data into disclosure accounting system in accordance with HIPAA standards.
• Completes payment handling tasks as assigned, which may consist of collecting credit card information, handling checks received by mail and posting payments in the ROI module.
• Corrects errors and incomplete information on forms as necessary when requested by a supervisor or physician.
• Completes simple forms as set forth on the MEA Approved Forms list, maintained by the HIMS Department.
• Run delinquency report from HealthConnect and resolves open items on that report with physicians in the assigned MOB.

Member Experience

• Assists members in a professional manner that promotes a positive customer service experience.
• Provides members with general information, and/or refer them to appropriate department as necessary.
• Responds to member inquiries related to changes or corrections to the things like: name, date of birth, gender, other demographic information, and PCP assignment and center changes.
• Initiates member issue to fix when one member has two different medical records.
• Documents compliments in Macess.
• Orders HIPAA Certifications.
• Validates basic benefit information related to copay, co-insurance, deductibles and other KP plans.
• Document member inquiries in CHATS.
• Performs referral status look-up in Healthconnect.
• Orders of new or replacement IDs.
• Maintains knowledge and training (from KP Learn) on all information systems necessary to perform duties.
• Assists patients with navigating KP systems including kiosks and way-finding.
• Respond to voice mail in a timely fashion.
• Performs other duties as directed.
• Orients and train new staff.
• Wears professional attire to include a KP-provided jacket.
• Performs the duties of the Receptionist and Administrative Assistants as necessary.