Health Information Management Specialist Level II
Gouverneur Health
Queens Hospital Center is making good on its promise to the people of southeastern and central Queens to maximize both patient convenience and positive clinical outcomes. Residents of Queens can count on the delivery of quality medical care right in their own borough. In 2002 the hospital opened a state-of-the-art, 261-bed facility that includes the Queens Cancer Center, the first comprehensive cancer treatment center in the borough.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons. Work Shifts 9:00 A.M - 5:00 P.M 35 Hours Duties & Responsibilities Purpose of Position :This class of positions encompasses supervisory and/or administrative work of varying degrees of difficulty and responsibility in the field of health information management. Performs quality review of records and/or documentation provided by clinical staff. Contributes to, and ensures the appropriateness of code and Diagnosis-Related Group (DRG) assignment in order to facilitate consistency, accuracy, and efficiency in claims processing, data collection, and quality reporting. All personnel perform related work.
Under general supervision, directs, coordinates, and supports the daily activities and services in an assigned department(s), unit(s) or area of service.
Examples of Typical Tasks :
At a more difficult and responsible level, performs the duties of Assignment Level I:
1. Validates the completeness, accuracy, and specificity of code assignments for inpatient, outpatient, and ambulatory surgery records in accordance with established coding guidelines. Ensures that all documented diagnoses and procedures are properly coded.
2. Validates the accuracy of DRG assignment.
3. Validates the accuracy of additional information abstracted from the clinical record.
4. Monitors denials and appeals. Performs DRG denial reviews for appropriate parties. Ensures that denials are responded to in a timely manner; submits monthly reports.
5. Monitors data integrity and accuracy; makes necessary data corrections and entry. Performs chart review to determine data quality.
6. Identifies and reports on cases with documentation inadequacies, inconsistencies, and other issues with opportunities for improvement. Evaluates root causes and proposes corrective action for same.
7. Generates physician queries as needed in order to obtain clarification of medical record documentation. Validates that physicians have been queried according to established procedure.
8. Confers with coding specialists, and oversees and evaluates work performance. Provides ongoing and specific feedback to coding staff and management team regarding review findings.
9. Provides education and training to new and existing health information management staff.
10. Instructs physicians, nurses, health information management staff, and other appropriate personnel regarding documentation requirements as related to coding.
11. Works with other departments to ensure that accurate reporting and reimbursement are facilitated.
12. Assigns codes for diagnoses and procedures according to the current classification system for inpatient, outpatient, and ambulatory surgery records and in accordance with established coding guidelines.
13. Performs concurrent and retrospective clinical documentation review and provides data when necessary.
14. Reviews and analyzes clinical records for compliance with appropriate regulatory requirements.
15. Effectively utilizes computer applications and other coding and abstracting software and hardware as necessary.
16. Performs other related duties as assigned or directed.
In addition to performing the duties of Assignment Level I at a more difficult and responsible level, as described above, also performs the following:
1. Assists in the development, implementation, and management of organizational strategy, initiatives, and/or budget and performance standards; communicates organizational objectives and goals.
2. Serves as departmental representative through participation in various facility and corporatewide committees, work groups, and/or initiatives.
3. Assists in interdisciplinary efforts to review existing documentation and coding policies and procedures and makes necessary recommendations for improvement.
4. May assume responsibility for supervising and/or directing assigned personnel as appropriate and required. Minimum Qualifications
1. Possession of a Registered Health Information Administrator (RHIA) credential from AHIMA and two (2) years of satisfactory experience in coding and abstracting medical records in a recognized hospital or health care organization, of which one (1) year has been in a supervisory and/or administrative capacity; or
2. Possession of a Registered Health Information Technician (RHIT) credential from AHIMA and four (4) years of satisfactory experience in coding and abstracting medical records in a recognized hospital or health care organization, of which two (2) years have been in a supervisory and/or administrative capacity; or
3. Possession of a valid certificate as a Certified Coding Specialist (CCS) from AHIMA and six (6) years of satisfactory experience in coding and abstracting medical records in a recognized hospital or health care organization, of which three (3) years have been in a supervisory and/or administrative capacity; or
4. A satisfactory equivalent of education and experience. Benefits NYC Health and Hospitals offers a competitive benefits package that includes:
- Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
- Retirement Savings and Pension Plans
- Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
- Loan Forgiveness Programs for eligible employees
- College tuition discounts and professional development opportunities
- College Savings Program
- Union Benefits for eligible titles
- Multiple employee discounts programs
- Commuter Benefits Programs
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