HIM Specialist I

Job Title

The position supports day-to-day HIM operations across multiple hospitals and multiple HIM functional areas (Data Integrity, Document Imaging, Birth Registry, Deficiencies, ROI). Ensures records are accurate, complete, and timely and protects PHI per HIPAA and HITECH and policy. Primary responsibilities: process and route documents and images; index and scan with quality checks; basic patient and encounter validation; approved demographic and chart updates; straightforward requests (minimum necessary). Documents work and escalates discrepancies and exceptions per policy.

Responsibilities

Essential Functions

Data Integrity Maintains the integrity of the Master Patient Index (MPI) by monitoring and researching patient demographics, identifying potential duplicate patients, and reporting potential patient overlays. Triages, assigns and/or manages assigned chart correction cases or tasks on a routine basis and follows up with all members tasked within the case to ensure timely resolution. Reviews and processes externally received inbound messages from various health information exchanges to enable and support patient care in the electronic medical record. Ability to gain additional knowledge and skills about the functions of the department.

Document Imaging Prep, scan/import, and index patient documents in the document management system ensuring proper document type, patient encounter, account, invoice, guarantor, and other indices follow indexing guidelines/requirements. Perform basic quality checks to ensure documents are clear, accurate, and properly filed. Demonstrates clear understanding of all applications utilized to perform core work, processes, and workflows understanding how documents are generated, received, stored, organized, transferred, and managed between all systems/applications.

Birth Registry Collect all data elements mandated by state regulations and required for accurate birth certificate preparation. Update baby's name given by parent(s)/legal guardian(s) in the Comprehensive Health Record within a timely manner. Visit/calls parents to review and obtain signatures on birth certificate forms and provide informational packets. Enter accurate birth information into the Electronic Vital Statistic System based on the timeframes established by the state

Deficiencies Management Perform medical record analysis across multiple service lines, multiple hospitals including, but not limited to, Emergency Department, Outpatient and Inpatient records to ensure documentation accuracy and compliance per the Medical Staff Rules & Regulations, Medical Staff Bylaws, Joint Commission, and other regulatory requirements. Assign appropriate deficiencies to physicians, residents and allied healthcare professionals for completion of their medical records when appropriate Manage assigned deficiency-related work queues with attention to accuracy, timeliness and workflow efficiency. Perform verification of the record elements to finalize the records with assistance, is needed.

Release of Information Efficiently retrieves, opens, sorts, and routes incoming correspondences received via mail, e-mail, and faxes ensuring timely handling and accurate documentation. Identifies record request types to ensure they are routed to the appropriate work queue for processing. Accurately logs, tracks, and verifies that all requests meet processing requirements to ensure compliance with all Orlando Health's policies, in addition to federal and state law surrounding patient privacy and security. Delivers high-quality support via phone and in person interactions, resolving inquiries and facilitating record access with professionalism and empathy. Facilitates the release of records during the fulfillment process by securely sending only the minimum necessary information requested in the format and delivery method required by the requestors at the hospital or through work queue requests Monitors and manage all ROI-related work queues, prioritizes tasks and releases based on departmental needs and service excellence. Retrieves patient information from archives, paper file systems, legacy applications, or any other system/application that contains the legal medical record or records otherwise being requested and assembles in a standardized fashion.

Reviews all documentation such as chart notes, flags, alerts, etc. for sensitive information prior to processing a release to ensure release meets compliance with patient privacy standards / requirements Prepares and monitors all correspondences to requestors by ensuring timely completion of medical record requests. Provides accurate invoices of releases by understanding required fee structures and performs follow-ups with requestors to guarantee full payment is received and processed when applicable. Exhibits proficiency in and disseminates the knowledge of state statutes, federal rules/laws (HIPAA, HITECH, etc.,), and all other rules or guidelines relating to releasing protected records and uses appropriate judgement in releasing records. Assists with the preceptorship of new hires/existing team members. Develops working knowledge of the full Release of Information workflow within the various systems and resources identifying and resolving issues when there are breakdowns in the processes.

General Meets productivity, timeliness, and quality standards and goals set by the department. Provides data for monitoring productivity and outcomes through maintenance of spreadsheets, databases, and/or other documentation processes. Maintains thorough knowledge of state statutes, federal rules/laws (HIPAA, HITECH, etc.), and all other rules or guidelines relating to releasing protected records and uses appropriate judgement in releasing records. Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards. Maintains compliance with all Orlando Health policies and procedures. Demonstrate exemplary customer service when interacting with a customer by always being alert, respectful and professional while proactively identifying the needs of a customer and mitigating concerns quickly. Assume responsibility and engage in professional growth and development by completing required training and recertification to enhance job performance. Perform additional duties as assigned by departmental leadership. Communicates cooperatively and constructively with physicians, patients, guests, and all other members of the healthcare team demonstrate excellent interpersonal, oral, written, and organizational skills. Serve as a resource for all HIM team members, providing guidance and support, and fostering professional growth to ensure team success and alignment with organizational goals.

Other Related Functions Maintains security and confidentiality of patients and hospital data and information. Ability to maintain a positive attitude and adapt to a changing environment. Demonstrate flexibility, float to other sites/functions as needed by the department, help support special project requests, and in general is open to change when necessary. Demonstrates critical thinking and process improvement skills. Promptly report any improper handling of PHI to include breaches or other HIPAA reportable offenses to manager when discovered and enter an Event Report as appropriate. Demonstrate strong organizational skills, maintained exceptional attention to detail, and ensured accurate data entry, verification, and updating as required. Demonstrated ability to read and comprehend medical records documentation through knowledge of medical terminology and anatomy/physiology. Possess and applies knowledge of clinical and registration / demographic system information in all applications required to navigate the medical record, reason, and solve problems. Work independently with minimal supervision, showing initiative, accountability and sound judgement. Maintains level of productivity established by department Attends other education sessions and designated meetings as assigned Maintains HIM ladder expectations assigned to a Level I - HIM Specialist I

Qualifications

Education/Training High School Diploma or equivalent required. Type a minimum of 30 words per minute. Basic proficiency in Microsoft Windows operating system. Basic proficiency in Microsoft 365 applications (Word, Excel, Outlook, PowerPoint). Medical Terminology preferred or within 1 year of hire.

Licensure/Certification None required.

Experience One (1) year of experience in Health Information Management (HIM), Revenue Management or Revenue Cycle, or a Healthcare field preferred. Completion of Health Information Management, Healthcare Informatics, Health Information Technology, or Health Service Administration degree program can substitute for one (1) year of experience preferred.