Health Information Manager

Title:

Health Information Manager Reporting Relationship:

Chief Financial Officer General Summary of Responsibilities:

Planning, coordinating, organizing, directing, and controlling the activities of the Health Information Department and Chart Audit Department to best support of the needs of the patients, the healthcare Providers, and the Hospital. The Manager supervises approximately thirteen employees.

The Manager also serves as:

The HIPPA Privacy Officer for the Hospital, the Hospital owned clinics, and the Hospital's employee health benefit plan. In that capacity the Manager oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization's policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and the Hospital's information privacy practices. The RAC (Medicare Recovery Audit Contractors) Officer for the Hospital. In that capacity the Manager coordinates all internal RAC functions beginning with the initial notification of an audit to closure of the audit.

Essential Job Functions:

Health Information Management Direct and coordinate functions of the Health Information Department to assure these functions are carried out efficiently, accurately, and in compliance with hospital policies and regulatory agencies including JCAHO, the Quality Improvement Organization (QIO), Medicare and Medicaid. Assure medical records are kept in a confidential manner and information is released only to authorized individuals. Assist the Medical Staff, Utilization Review, Quality Management, Infection Control, and Risk Management as necessary to carry out required review activities. Assure that monthly statistics are compiled and reported to Administration and Federal and State agencies as required. Perform administrative functions of the department such as budgeting, planning, employee evaluations, authorization of time cards, hiring and discipline of employees, conducting staff meetings, etc. Develop and monitor internal quality assessments and productivity standards for HIM functions. Respond to all appropriate requests for information from hospital personnel and outside agencies (Cancer Registry, Head/Spinal Cord Injuries, etc.). Participate in the approval and printing of all permanent medical record forms. Establish and maintain effective departmental policies and procedures. Develop and coordinate educational programs for the department on a regular basis. Organize and follow through on activities originating in the Tissue Record/Utilization Review Committee to include the performance improvement monitor of medical records. Audit physician's incomplete charts weekly and utilize the delinquent record procedure on those records that are incomplete. Ensure that billing information is released timely (within six days of discharge) and accurate through the ICD-9 or ICD-10 and CPT coding of outpatients, and the ICD-9 or ICD-10 coding and DRG assignment of inpatients. Facilitate, with assistance from other key departments, the organization's transition from ICD-9 to ICD-10. Coordinate education on ICD-10 for providers and hospital staff. Serve on the following

Committees:

Quality Management, Safety, Electronic Health Record, Medical Record/Utilization Review, HIPAA, and Chargemaster. Manager may be required to serve on sub-committees or ad hoc committees, as needed. Manager will attend monthly Medical Staff meetings. Continue to increase knowledge of all medical record functions by reviewing journals and periodicals and attending appropriate in-services and workshops. Maintains up-to-date documentation of the procedures specific to this job description. Other duties as assigned. Chart Audit Provide oversight and direction for chart audit activities to ensure that revenue is recorded timely, that billing statements accurately reflect charges for services and supplies received by patients, and, that chart documentation meets organization and industry quality standards. Provide leadership in promoting point-of-service charge initiation. Develop, build and maintain automated charging processes in collaboration with various constituents, including: Information Technology (and Nurse Informatics), Electronic Health Record Committee, Chargemaster Committee, Nurse Educators, Nursing, and Ancillary Departments. For manual charge systems, promote point-of-service systems that are well defined as to responsibilities, expectations and outcomes, again working through inter-departmental teams. Analyze added and deleted charge data to identify trends indicating degradation in the integrity of established charge processes. Initiate concurrent and focused audits anytime a change is planned and known to cause revenue cycle breakdowns.

Examples of such events include:

introduction of new service lines, expansion of service lines, hospital software upgrades, changes in 3rd party vendors supplying interfaced systems (i.e., change from Pyxis to Omnicell), updates to 3rd party systems, etc. Other duties as assigned. HIPPA Privacy Officer Provide developmental guidance and assist in the identification, implementation, and maintenance of the Hospital's information privacy policies and procedures. In collaboration with the HIPPA Security Officer, will perform initial and periodic information privacy risk assessments and conduct related ongoing compliance monitoring activities in coordination with BBGH's other compliance and operational assessment functions. Work with legal counsel and management, key departments, and committees to ensure the organization has and maintains appropriate privacy and confidentiality consents, authorization forms, and information notices and materials. Oversee, direct, deliver, and ensure delivery of initial privacy training and orientation to all employees, volunteers, medical and professional staff, contractors, alliances, business associates, and other appropriate third parties. Establish a mechanism to track access to protected health information, within the purview of the organization and as required by law and to allow qualified individuals to review or receive a report on such activity. Ensure that patients are provided the right to inspect, amend, and restrict access to protected health information when appropriate. Establish and administer a process for receiving, documenting, tracking, investigating, and taking action on all complaints concerning the Hospital's privacy policies and procedures in coordination and collaboration with other similar functions and, when necessary legal counsel. Serve as the chairperson of the Hospital's Privacy Committee. Cooperate with the Office of Civil Rights and other legal entities in any compliance reviews or investigations. Other duties as assigned. RAC Officer Serve as Chairperson of the hospital's RAC Committee. Track the status of all RAC activity using an automated or manual tracking system. Coordinate all activities across departments associated with RAC requests, appeals, etc. Manage RAC audit timeline compliance for record request submissions and responses. Communicate with all affected external entities involved in the RAC process. Analyze audit and RAC findings. Report findings and performance improvement opportunities to the RAC Committee, affected departments, and Corporate Compliance. Follow all RAC activity to closure. Other duties as assigned.

Other Job Functions:

Perform technical functions of the department, as necessary. Maintain professional certification(s). Attend mandatory in-services, trainings and meetings.

Job Qualifications:

Education:

Required:

Associate of Applied Science Degree Preferred:

Bachelor of Science/Arts Degree in

Health Information Management License/Certifications:

Required:

Registered Health Information Technician (RHIT) within 3 years of hire and valid and current drivers license

Preferred:

Registered Health Information Administrator (RHIA) All offers of employment are subject to a background check and drug screen. EOE.