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GENERAL SUMMARY OF POSITION:

Under the general supervision of the Operations Manager, this position is responsible for the preliminary review, direct processing, and expediting of all incoming and outgoing written and electronic correspondence and records, including disability supplements, medical and clinical information, and related materials. This position makes complex decisions regarding protected healthcare information (PHI)  based on the Federal regulations regarding the protection of health information under the Health Information Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.  This position is the primary hub for all incoming/outgoing correspondence, disability supplements, and is the primary interface with clients, agencies, and DES staff regarding incoming and outgoing medical information, mail, and records.

In addition, this position provides the primary initial mailing, receipt, review, and customer service functions for disability supplements (MassHealth or other clients).  Decisions made in this area directly impact the timeline for the disability review process and for the determination of benefits for MassHealth and other agency applicants.  

MAJOR RESPONSIBILITIES:

• Performs initial review of all disability supplements, for accuracy, completeness and to ensure the application is compliant with all the state and federal regulations.
• Coordinates and performs complex and varied administrative tasks related to medical information, records, and disability supplements requiring independent action and the setting of priorities and procedures.
• Compares the status of all supplements received with external client databases and internal databases; create MassHealth or other client tracking forms with client demographics for processing by DES staff
• Manages the receipt of electronic medical records through use of an UMass secure file transfer protocol (SFTP) site, and ensures distribution of the information to the appropriate DES staff.
• Performs scanning functions on incoming records and correspondence for all DES programs.
• Maintain accuracy of all information in cases comparing information in client databases (MA21 or other sources), with the information in multiple DES databases.
• Responsible for opening, sorting, receiving, and date stamping all correspondence received at DES.  Date stamps all written and faxed correspondence and other materials including medical records.
• Performs data entry for specific client information into State database (MA21 or other) and DES databases during the intake process, such as received date, mail date, notes to household, progress notes, and other related information; delivers mail and medical information, files medical information  in medical records, files all other correspondence within DES program guidelines.    
• Interfaces with Client Enrollment Centers (MassHealth or other) to ensure proper processing of disability supplements, and with the UMMS centralized mail room to coordinate courier delivery and pickup.  Prepares correspondence notices sent electronically for general mail, faxing, UPS, express services, and UMMS courier.
• Conducts electronic research regarding client application location and status in state databases (MassHealth or other) Virtual Gateway, and DES databases.
• Handles customer service calls related to client disability supplement submissions from both clients and state staff (MassHealth or other), making decisions based upon the conversation.
• Identifies Unit process flow issues and makes recommendations for improvement.
• Compiles data onto spreadsheets regarding mail and file workload and activity and reports information to supervisor on both a recurring and ad hoc basis.
• Coordinates and performs confidential and varied administrative tasks requiring independent action and the setting of priorities and procedures. Maintains confidentiality in all aspects on correspondence handling.
• Makes decisions on medical information release requests for compliance with HIPAA regulations, and ensures that information is obtained and released in accordance with state and federal regulations.
• Determines if requests for medical records are legally complete, communicating with agencies about request that do not meet HIPAA requirements for PHI.
• Prepares correspondence, memoranda, and correspondence letters to various state agencies (MRC and others), advocates, attorneys, and clients that are requesting medical records.
• Expedites the request for medical records at offsite archiving vendor and in the DES file room. Monitors and tracks all medical releases in a data base.
• Corresponds and communicates daily with advocates and agencies handling sensitive and confidential medical records for clients at DES.
• Works in a team environment to assist with large mailing projects including copying, collating, envelope stuffing, retrieval of electronic files, scanning, and indexing.
• Maintains organization in the DES business center including prioritizing routine and project photocopying requests and keeps business photocopiers and fax machines equipped with paper, toner, and report repairs.
• Assists in special projects with medical records management. Works in a team environment to assist in the Operations Department with varied duties.
• Organizes information into spreadsheet format for data collection. Enters all requests for medical records electronically into the DES computer system.
• Participates in quality improvement initiatives within the Operations Unit and DES.
• Provides administrative supports for the DES reception area by answering phones, providing information, responding to questions, and directing calls, and/or visitors as needed.

REQUIRED QUALIFICATIONS:

• Associate’s degree in business, a related field, or equivalent experience
• 2 years of relevant office experience
• Demonstrated knowledge of medical terminology or willingness to take a course in Medical Terminology.
• Knowledge of HIPAA laws and regulations and/or an understanding of the importance of confidentiality of PHI.
• Knowledge of Microsoft Office products, Word, Excel, PowerPoint, and Outlook.
• Requires organizational and excellent interpersonal skills, oral and written communications skills necessary to interact with all levels of personnel.