The posting
Job Description
Summary of Essential Functions:
- Reports to the Director of Patient Access and HIM in support of United Regionals Revenue Cycle structure and compliance of HIM related revenue cycle functions.
- Manages the compliance, strategic planning, financial strength, and overall performance of the HIM department in professional coding, hospital coding, release of information (ROI), chart preparation and indexing, physician deficiency management, and chart compliance and integrity through chart correction and auditing processes.
- Further, this individual is responsible for ensuring adherence to applicable governmental and payer regulations, as well as maintaining an HIM compliance plan in order to avoid penalties.
Educational Requirements:
- High School Diploma or equivalent.
- RHIA/RHIT preferred or Bachelor’s equivalent.
- Must be able to communicate effectively in English, both verbally and in writing.
Licenses and Certifications:
- Coding Certification(s) preferred
Knowledge/Skills/Abilities:
- Ability to mentor, delegate and develop personnel; lead department meetings; lead and organize training opportunities for all staff.
- Must have good communication skills to effectively communicate with on site and remote staff.
- Must be able to communicate professionally and train providers in several aspects of HIM to include documentation standards, deficiency and suspension, and training of front end dictation software.
- Must have extensive IT knowledge as is relates to third party coding and CDI systems, Front end dictation and transcription software and Epic software support.
- Must have knowledge and ability to use Microsoft Office products.
Duties and Responsibilities:
- Manages all members and facets of HIM operations including ROI, chart preparation/completion, coding, and ensuring chart compliance.
- Plans and organizes the daily activities of the HIM department while maintaining responsibility and accountability for operations within HIM department.
- Support United Regional’s passion, purpose and pillars while also aligning department goals in support of organization goals.
- Responsible for proper utilization, user access and system training in Coding third party software systems and Transcription/Front end Dictation software systems. This includes assistance in upgrade build projects with the IT department.
- Assist Medical Staff with rules and regulations on Incomplete Chart Requirements to meet regulatory agencies' requirements as well as legal documentation requirements, monitors and reports non-compliance to Executive Staff and Senior Leadership.
- Participates in the development, implementation, and updating of HIM policies and procedures through policy manager.
- Helps select and onboard qualified candidates into the HIM department in order to assure high levels of performance while verifying current certifications/licensure before hiring and as appropriate.
- Plays an active role in orienting and mentoring staff to ensure quality and productivity standards are consistently met.
- Provides annual and ongoing performance feedback for all staff within the HIM department while ensuring timely completion of evaluations and counseling.
- Creates opportunities for professional growth for HIM staff and encourages staff to pursue further career development along with assisting in scheduling continued training for up-to-date rules and regulations as it pertains to all areas of the department.
- Maintains a constant presence for HIM staff by attending and periodically presenting during team meetings.
- Works with system support staff to ensure the maintenance of HIM operational systems and resolve technical problems, as needed.
- Ensures that all HIM operations are in compliance with local, state, and federal regulations, especially with regard to the privacy and security of protected health information and coding compliance.
- Monitors coding production and charge capture through CFB, delinquent charts and other applicable reports. Works with patient accounting and other leaders within the organization to address workflow hurdles impacting revenue as soon as they arise.
- Provides regular updates to the Revenue Cycle Leadership regarding daily operations and concerns.
- Thorough understanding of ICD-10, CPT, and HCPCS code sets.
- Helps Coding and CDI manage RAC denials related to the HIM department and ensures timely response and improvements to prevent future denials.
- Collaborates with Revenue Cycle leadership, Privacy Officer, physicians, compliance specialists, and other departments to promote optimal efficiencies throughout the revenue cycle and HIM.
- Adheres to prompt completion, filing, and retrieval of medical records.
- Assists in planning the delivery of services such as record retrieval, record maintenance, data management, medical record completion, or release of information.
- Responsible for the annual coding changes, adhere to changes, and ensure staff have updated materials both in and outside of coding assisted software.
- Ensures chart corrections, patient MRN merges, and chart integrity amendments are completed in a timely manner to help prevent possible clinical errors.
- Assists in all Epic upgrades quarterly to give input on new updates and decisions about workflows and functionality. In addition to ensuring all staff receive updated training materials for each change.
- Maintains and ensures patient confidentiality at all times.
- Maintains necessary controls and appropriate reviews of medical coding to ensure accuracy and compliance along with partnering with outside independent organizations for audit purposes.
- Provides routine reports to different areas within the hospital and clinic leadership in reference to HIM statistics related to those areas.
- Participates in budget development and responsible for tracking and monitoring expenses to stay within budget.
- Adherence to administration of general safety policy and procedures.
- Works with managers, directors, and frontline staff to meet and/or exceed key performance indicators within all HIM departments.
- All other duties as assigned.
