PURPOSE OF THE JOB
Oversee, lead, plan, manage, and supervise the day-to-day operations of Health Information Management Services (HIMS) department and its staff. Develop goals, operating budget, policies, and procedures that are consistent with BBAHC policy and any legal and governmental regulations. Incumbent is the designated Privacy Officer.
ESSENTIAL FUNCTIONS
Collaborates with senior leadership to set annual, monthly, and weekly operational goals and executes a detailed plan according to HIMS best practices, legal and regulatory requirements, and professional standards.
Knowledge of information privacy laws, access, release of information, and release of control technologies including but not limited to: CFR 42 part 2, HIPAA, and HITECH.
Advanced knowledge of medical terminology, anatomy, Coding Guidelines, ICD-10CM, CPT-4, HCPCS coding, patient care documentation standards, and auditing concepts and principles.
Aligns HIMS staff with BBAHCs mission, vision, core values, and strategic goals. Prepares new team members with thorough onboarding through coaching skills to build their expertise in customer service and HIMs procedures.
Conducts routine performance audits and reviews to ensure compliance with departmental, organizational, regulatory policies, and compliance standards. Including but not limited to corrective action plans and periodic staff performance evaluations.
Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations. Obtains clarification of conflicting, ambiguous, or non-specific documentation. Trains providers and coders as appropriate regarding coding compliance documentation, regulatory provisions, and third-party payer requirements.
Establishes and administers a process for receiving, documenting, tracking, investigating, and acting on all complaints concerning the organizations privacy policies and procedures in coordination and collaboration with other similar functions and, when necessary, legal counsel.
Reviews all system-related information security plans with the Security Officer throughout the organizations network to ensure alignment between security and privacy practices and acts as a liaison to the information systems department.
Works with all organization personnel involved with any aspect of release of protected health information, to ensure full compliance with organizations policies and procedures and legal requirements.
Maintains current knowledge of applicable federal and state privacy laws and accreditation standards, and monitors advancements in information privacy technologies to ensure organizational adaptation and compliance.
Establishes control procedures to optimize efficient and effective handling of patient records and related documents, including acquisition of new equipment, and revision of medical record forms and reports.
Coordinates utilization of health information services such as research, utilization, medical audits, performance improvement studies, disability evaluations, and other BBAHC operational needs.
Provides consultative services in the areas of record-keeping practices to administration and programs.
Evaluates and determines present and projected needs for Health Information Management systems and data in relation to patient care, medical and paramedical staff, education, research, and administration.
Maintains appropriate patient record controls and statistics for prospective payment systems to ensure compliance with CMS and other regulatory agencies.
Responsible for gathering medical records for auditors (including contract auditors, RAC, PERM, and others), and other third-party payors as needed.
QUALIFICATIONS
Associates degree in business, finance, or related field. Work-related experience may be substituted on a year-for-year basis in lieu of college education.
Current Certification in Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS)
Certified Professional Coder (CPC), Certified Documentation Expert Outpatient (CDEO), or Certified Documentation Expert Inpatient (CDEI)
Current Certification in Certified Healthcare Privacy and Security (CHPS) is required or obtained within one year of hire.
WORKING CONDITIONS
Must be able to see, hear, speak, walk, sit, bend, kneel and lift and carry up to 20 pounds with or without accommodation. Limited travel required to Anchorage or lower 48 for conferences and training.
POSITIONS SUPERVISED
Coders, Medical Records Technician, Records Analysts, and File Clerks.
SUPERVISED BY
Revenue Cycle Manager