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Jacksonville, FL 32257
Under the direction and supervision of the Medical Records Manager, the HIM Senior Specialist performs a wide range of duties related to the efficient and effective operation of the Medical Records Department. The HIM Senior Specialist is the team leader who will coordinate project plans and status and develop/maintain positive working relationships across the teams. They will function as a member of the Compliance team to assure optimum performance and productivity of the Medical Record department and assume responsibility in the absence of the Medical Records Manager.
Primary Duties and Responsibilities:
* Confidentiality: Adheres to the requirements of the HIPAA Privacy and Security Policies and Procedures. Maintains confidentiality of patients, families, and staff records.
* Customer Service: Performs job functions adhering to Alivia Care service values with customer service focus of innovation, service excellence, respect, and teamwork to provide the highest quality care and service to our patients, families, staff, and others.
* Compliant Documentation Practice: Monitors the documentation practices within the patient record in all settings, trending outcomes and reporting to leadership any regulatory or organizational non-compliance. Supports the development, implementation and management of medical record documentation and makes independent decisions in judgment using guidelines provided by leadership.
* Release of Information: Coordinates the Release of Information process which include requests from and to third party payers, providers, legal, patients/families, insurances, and others as well as processing the invoices for records requests. Assists in the outreaching to providers and healthcare facilities for medical records via phone, fax, mail, encrypted email, or EMR system retrieval.
* Records & e-MPI maintenance: Assists and coordinates all records maintenance practices performed by Medical Records staff. Processes, completes, and/or coordinates the Data Manipulation Requests (DMR) such as EMR data correction and changes. Processes, completes and/or coordinates the e-MPI (electronic Master Patient Index) cleanup processes such as data cleanup, duplicate records maintenance, etc….
* Registry Maintenance (i.e., Death Registry): Coordinates the death certificates and amendments processes according to state regulations and organization policy, facilitates the enrollment and training of new physicians and/or providers in the state Electronic Death Registration System (EDRS), and maintains a working relationship with external community partners such as Funeral Homes, Vital Statistics Office as well as other providers.
* Record Analysis & Deficiency Monitoring: Coordinates the medical records documentations audits, deficiencies, and analyses processes (such as orders, advanced directives, certifications, ) for compliance to regulatory requirements. Completes reviews of records audits completed by medical records staff and reports findings to Corporate Medical Records Manager. Serves as a resource to clinicians and other department to assure that all documentation procedures are consistent with established protocols and applicable regulations and requirements, reports deficiencies weekly.
* Coding/ Reimbursement: Coordinates the preparation of physician documentation for evaluation and management for coding audits to the coding team. Investigates date of death issues that impact reimbursement by coordinating with clinical and/or financial staff, Compliance and Corporate Medical Records Manager and/or the Social Security Administration, funeral homes, and external facilities to facilitate the correction of dates of death.
* Quality Improvement: Participates in department quality assurance activities; assists in the achievement of overall department goals and objectives. Review processes and systems on an ongoing basis to determine where improvements can be made.
* Other Duties: Prepares and assigns schedules to medical record staff and monitors for completion and accuracy. Assists the Corporate Medical Records Manager with the orientation and ongoing training of processes to medical records staff and volunteers. Notarizes certified records and other documents as needed. Maintains office supplies and inventories, monitors supply cost and usage for the Compliance Department and Admissions Department. Assists management with special projects and performs other duties that are related and appropriate to the department. Assists the Corporate Medical Records Manager with processing external EMR records requests for Alivia Care and partners. Assists the Corporate Medical Records Manager with processing EPIC EMR access requests for Alivia Care and partners.
Qualifications:
Education/Experience:
Typical qualifications would be equivalent to:
* Associates or Bachelor’s degree in HIM preferred.
* High School Diploma or equivalent required
* Three (3) to four (4) years of medical records experience required.
* ICD-10 coding and CPT coding knowledge preferred
Knowledge of:
* Health information standards and regulations;
* HIPAA Privacy and Security Standards;
* Medical terminology;
* Computer software including use of Microsoft Outlook, Word, Excel, Adobe PDF, as well as EMR and medical record document management systems experience.
Skilled at:
* Demonstrate high attention to details.
* Multi-tasking;
* Communicating both written and verbal to provide superior customer service.
* Analytical thinking for effective problem determination and resolution;
* Working independently and as a team member and making decisions under pressure, while providing timely and responsive services;
* Prioritizing work using fundamental time management skills.
* Being creative, detail oriented, and professional.
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