HIM Specialist

General Description:

The HIM Specialist is primarily responsible for assisting the HIM Operations Manager by routinely performing duties in support of the management of the Horizon Patient Folder (HPF) workflow queues, the resolution of unbilled accounts, and the processing of physician suspensions. In addition, the HIM Specialist serves as the primary point of contact when the HIM Operations Manager and/or HIM Coordinator is unavailable. Primary duties noted below should encompass more than 50% of the workday for this position title to be used.

Essential Responsibilities:

• Resolves accounts in one or more assigned HPF work queues (e.g. Cancelled Accounts, Unknown Documents, Facility HIM, Workflow Trigger and Coding Pend for Queues), which requires research and analysis to determine the appropriate action to be taken.
• Resolves unbilled accounts which is critical to revenue cycle management; may spend significant time researching and analyzing while utilizing Meditech and HPF; determining which issues belong to which department, working with the appropriate department, following up with the department or physician to clear the accounts, and ensuring the accounts move through the system.
• Assists in resolving accounts in the eRequest queue, which includes, but is not limited to, payment window accounts, requests for sterilization forms and pre-certifications.
• May coordinate or be instrumental in the physician suspension process, evaluating if documentation or circumstances warrant a physician be put on suspension and creating the list of recommended suspensions for approval. This requires understanding the facility's guidelines and requirements necessary to trigger suspension. May oversee other clerks in completing more routine duties related to incomplete record status and suspension letters and in making physician calls.
• Provides support to the birth certificate process, if L&D services are available, which requires interacting with parents, using diplomacy and sensitivity, to obtain accurate information required by the state for birth certificates and acknowledgment of paternity (AOP) forms. Some states require certification to perform the duties of a birth certificate clerk.
• Assumes responsibility for the HIM department when HIM Operations Manager and/or Facility Coordinator is unavailable, with the ability to handle the majority of issues and inquiries that may arise.
• Assists the HIM Operations Manager and/or Facility Coordinator in gathering statistics for HIM reporting, to include documentation for timeliness of History and Physicals and Operative Reports.
• Proficient in addressing physician questions, issues and any training needed for the HPF system and providing training to any external reviewers or HPF users.
• Meets or exceeds established productivity and quality standards.
• Practices and adheres to the Company's Code of Conduct philosophy and Mission and Value Statement.

General Responsibilities:

• May assist with release of information (ROI) requests, which involves interacting in person or over the phone with patients and giving instruction/assistance in completing the ROI request process.
• May assist with merging duplicate accounts, which requires research and problem solving to ensure that the duplicate accounts are one and the same patient and determine which account number to be used.
• May assist with chart pickup, as time permits, and with reconciling retrieved medical records against patient discharge lists, ensuring receipt of all records within 24 hours of patient discharge.
• Assists in setting up external review queues when necessary
• Support the completion of physician queries by calling, monitoring and assisting physicians with the HPF application
• May batch, label and route loose reports, late charts/documentation for scanning and may scan and index loose reports/documents that are critical to coding, prioritizing according to policy.
• May coordinate storage, archival and record retention of unscanned documents and retrieval of medical records as needed.
• Processes facility specific HIM mail as applicable
• Other duties as assigned.

Minimum Qualifications:

Education: High school graduate or equivalent required

Experience: Two (2) years' experience in an office or hospital environment preferred. Previous experience in the handling of patient health information and/or medical records is strongly preferred.

License(s)/Certification(s)/Registration(s) Required: None

Knowledge, Skills and Abilities:

Adaptability - maintaining effectiveness when experiencing major changes in work tasks or the work environment; able to adapt to change in environment, work structure/processes, or requirements positively and proficiently. Able to multitask effectively. Work may be stressful at times.

Communications - communicates clearly, proactively, and concisely with all key stakeholders; able to maintain effectiveness when dealing with difficult situations or people.

Continuous Improvement - originating action to improve conditions and processes; identifying improvement opportunities, generating ideas and implementing solutions.

Customer Focus - ensuring that the customer perspective is a driving force behind decisions and activities; implementing services and practices that meet the customers and organization's needs. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.

Decision-making - identifying and understanding issues, problems, and opportunities; comparing data from different sources to draw conclusions; using effective approaches for solving problems and taking action.

Initiating Action - takes prompt action to accomplish objectives; responds quickly and independently, and takes action that goes beyond the job requirements in order to achieve objectives.

Planning & Organizing - establishes courses of action for self and others to ensure work is completed efficiently; prioritizes critical activities and assignments; stays focused and uses time effectively, preventing irrelevant issues or distractions from interfering.

Quality Orientation - accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.

PC Skills - Proficiency in computer skills and some knowledge of regulatory compliance.