Patient ID Specialist

Under indirect supervision, investigates and resolves outpatient medical record discrepancies for Region; maintains and assures system integrity of Regional Master Patient Index systems.

Is responsible for answering first calls into department and triaging as appropriate; processes calls with professionalism, courtesy, accuracy, and efficiency; interprets and handles difficult calls while demonstrating a positive image reflecting well on organization. Receives and processes regional requests to set up individual on Mater Patient Index system and responds in timely manner; maintains statistical information on number assignment; reports findings to supervisor. Maintains Regional Master Patient Index system; assures data integrity and reliability; cross-references demographic information after validation; monitors accuracy of user data entry. In addition, maintains user tables to support system; monitors and maintain synchronization between Master Patient Index system, ancillary systems, and KPHC; resolves discrepancies in system by investigating and analyzing situation. In addition, works with system administrators region-wide to ensure data integrity of patient demographics for Region. Collaborates and Assists Patient ID Specialist staff as appropriate to coordinate and implement improvements; identifies issues around improvements; suggests ideas to improve operation of area; works with fellow staff towards continual improvement of set service standards. In addition, resolves issues around improvements. Maintains patient confidentiality; processes discrepancies of outpatient medical records for Hawaii Region; investigates discrepancies as applicable; reviews medical history; obtains individual data from other Kaiser systems; compiles and organizes information; analyzes information to determine outcome. Identifies and analyzes discrepancies with multiple records on individuals; researches patient information in each available module within KP HealthConnect (e.g., ambulatory, registration, appointment, billing, admission/discharge/transfer, chart tracking, surgery, HIM, and KPHC online, etc.); prepares reports and provides to Patient ID Specialists for resolution. In addition, resolves discrepancy by consolidating multiple records on individual and reconstructing multiple records when more than one patient is incorporated in one chart; notifies appropriate departments as needed. Assures departmental and organizational quality of service standards are upheld; works with fellow Patient ID Specialist staff in identifying potential and existing barriers to maintain standards. Operates variety of office machines including: PC, printer, typewriter, fax machine, photocopier, embosser, address-o-graph, microfiche viewer, etc. Supports departmental and regional Total Quality Management (TQM) initiatives by actively participating in and supporting quality improvement projects. Collects and analyzes statistical codes; assures data integrity and reliability of user tables to support systems; cross-references demographic information after validation; resolves discrepancies in system by investigating and analyzing situation; monitors accuracy of user data entry; works with system administrators region wide to ensure data integrity of demographics for Region. Works with Clinic Systems Support Supervisor and other Patient ID Specialists to review and develop procedures; assists in monitoring results; recommends changes to ensure effectiveness and efficiency. Processes fraudulent cases involving outpatient medical record; investigates complaints as applicable; interviews persons involved to include patient; reviews medical history; obtains individual data from other Kaiser systems; compiles and organizes information; consults with appropriate authorities; analyzes information to determine outcome; resolves problem by reconstructing true record and creating fraudulent case record; notifies appropriate