Health Information Management Regulatory Analyst II

Default Work Shift:Day (United States of America)

Hours:

40

Salary range:

$26.42 - $40.15

Schedule:

Full Time

Shift Hours:

8 Hour employee

Department:

Medical Records

Job Objective:

Responsible for ongoing surveillance and maintenance of enterprise-wide Master Patient Indices and identity management in multiple source systems. Serves as a subject matter expert for questions, training, and troubleshooting issues. Coordinates all aspects of chart correction and chart merge for the enterprise. Coordinates regulatory workflow for patient requests for medical record amendment, including extensive communication with physicians. Assists Health Information Management (HIM) leadership in coordination of regulatory workflows, including release of information, and with surveyor, revenue cycle and data management activities, including state reporting.

Job Description:

Education:
Required: Associate’s degree in Health Information Technology, Health Information Management or related field

Licensure/Certification:
Required: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) from American Health Information Management Association (AHIMA)

Experience:
Required: Five (5) years of experience in a health information management department in an integrated health system
Preferred: Experience using Epic and OnBase

Reports To: Manager-Health Information Management Regulatory
Supervises: N/A
Ages of Patients: N/A
Blood Borne Pathogens: Minimal/ No Potential

Skills, Knowledge, Abilities:

Ability to adapt quickly to changing priorities and unexpected situations, Ability to collaborate and communicate with all levels of leadership, medical staff, colleagues, patients, regulatory representatives and other third-parties, Ability to demonstrate and apply effective critical thinking techniques, Ability to prioritize tasks and manage time efficiently to meet deadlines, Advanced computer skills and ability to manage complex data tracking, Expert knowledge of HIM workflows, including ability to perform medical record reviews and ability to investigate and troubleshoot complex medical record issues in multiple electronic platforms, Expert knowledge of state and federal medical records regulations, policies and procedures related to complex HIM workflows including master patient index, medical record correction, merge and medical record amendments, Knowledge of coding guidelines, including ICD-10-CM/PCS and CPT, Knowledge of federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing, Knowledge of Microsoft Office applications, including Powerpoint and advanced knowledge of Excel, Meticulous attention to detail and ability to maintain high-degree of accuracy, Written and verbal communication skills

Essential Responsibilities

1. Demonstrates compliance with Code of Conduct and compliance policies and takes action to resolve compliance questions or concerns and report suspected violations.
2. Manages and coordinates regulatory workflows for patient requests for medical record amendment, including extensive communication with physicians.
3. Collaborates with HIM leadership, Payer Relations and Denials teams to investigate and process advanced document requests for ADR audits; coordinates release activities with the release of information vendor; verifies processing and completion occurred within required timeframes.
4. Assists HIM leadership with regulatory survey activities by identifying and producing records and supporting compliance initiatives throughout the health system.
5. Works with HIM leadership and Quality department in managing medical records and data required to support various initiatives and data validation activities.
6. Coordinates with release of information vendor to support revenue cycle denial and appeals activities.
7. Generates and works various reports on a daily basis to develop the integrity of the enterprise-wide Master Patient Indices; verifies new medical record number assignments on a daily basis.
8. Performs daily resolution of all overlays and overlaps, coordinating resolution with ancillary departments and clinics as appropriate; completes cancellation and transfer of accounts, episodes of care and documents.
9. Manages and processes medical records marked for merge and correction; reviews reports for duplicate MPI numbers and resolves duplicates on a daily basis.
10. Coordinates maintenance and testing of ancillary systems with responsible parties to ensure consistency and integrity of all clinical systems; participates in testing of ADT systems related to merges/transfers in conjunction with testing of ancillary systems.
11. Performs medical record reviews; investigates and troubleshoots medical record issues in multiple electronic platforms; appropriately escalates complex issues to HIM leadership.
12. Assists HIM leadership with coordinating and performing quality assurance review and validation of birth registry documentation prior to submission to California Department of Vital Statistics.
13. Investigates any birth registry issues and facilitates the birth registry amendment process as needed.
14. Ensures birth registry data and documents are validated and submitted to third-party regulatory agencies, including Social Security and California Parentage Opportunity Program.
15. Assists HIM leadership with coordinating release of information activities.
16. Assists HIM leadership with Epic MyChart and Care Everywhere workflows within HIM’s scope, including over oversight and management of MyChart proxy authorizations, as well as state reporting, and assisting other healthcare organization with proper matching of patients in Care Everywhere.
17. Coordinates Advanced Health Care Directives and other legal documents, reviews for compliance and processing in the electronic medical record system, contacts and educates patients as needed regarding medical record management of planning documents.
18. Supports Privacy Code call center, assists patients, researches/investigates/resolves issues and escalates issues appropriately to HIM leadership.
19. Investigates and researches regulatory issues and requirements; identifies applicable state and federal requirements, such as for release of information and medical record amendments.
20. Works highly-technical Epic and other system work queues to resolve issues and insure accurate posting of patient information.
21. Performs quality assurance reviews of various HIM workflows and reports findings and recommendations to HIM leadership.
22. Serves as HIM Department subject matter expert for testing and validating system upgrades and implementation of new workflows and technology.
23. Develops training tip sheets and assists with educating HIM staff on Epic and other regulatory workflows.
24. Provides ongoing patient education and assistance on all areas of HIM services.
25. Assists HIM leadership with coordinating MyChart Committee meetings, MyChart communications and related activities.
26. Attends and participates in various meetings related to scope of work.
27. Performs other duties as assigned.