Medical Records Administrator

Summary The Chief - Health Information Management Section - Business Office is a Registered Health Information Administrator who is charged with full responsibility - both technical and administrative - for the daily operation of the Health Information Management Section which consists of all functions of medical record activities related to coding - analyzing - and release of information - transcription - file room and scanning programs. The Chief - Health Information Management Section - Business Office is a Registered Health Information Administrator who is charged with full responsibility - both technical and administrative - for the daily operation of the Health Information Management Section which consists of all functions of medical record activities related to coding - analyzing - and release of information - transcription - file room and scanning programs. Qualifications Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements Citizenship Candidates must be a citizen of the United States Non-citizens may be appointed when it is not possible to recruit qualified candidates in accordance with 38 U.S.C. 7407(a) Education or Experience Experience Three years of creditable experience in the field of medical records that included the preparation - maintenance - and management of health records and health information systems demonstrating a knowledge of medical terminology - medical records procedures - medical coding - or medical - administrative - and legal requirements of health care delivery systems Education Successful completion of a bachelor's degree or higher from an accredited college or university recognized by the U.S. Department of Education - with a major field of study in health information management - or a related degree with a minimum of 24 semester hours in health information management or health information technology Experience/Education Combination Equivalent combinations of creditable experience and education that equals 100 percent may be used to meet basic requirements For example - two years above high school from an accredited college or university - with 12 semester hours in health information technology/health information management - plus one year and six months of creditable experience that included the preparation - maintenance - and management of health records and health information systems meets an equivalent combination Certification Persons hired or reassigned to MRA positions in the GS-0669 series in VHA must meet one of the following: Coding Certification through AHIMA or AAPC OR HIM Certification through AHIMA OR Health Data Analyst Certification through AHIMA English Language Proficiency: Must be proficient in spoken and written English See 38 U.S.C. 7403(f) May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria) Grade Requirements: Medical Records Administrator (Chief (CHIM)) - GS-13: In addition to the basic requirements for employment - the following criteria must be met when determining the grade of candidates: Experience: One year of creditable experience equivalent to the next lower grade (GS-12*) level that demonstrates the KSAs described at that level *Examples of duties at the GS-12 include - but are not limited to: Skill in managing various projects and processes - which includes the ability to develop new or improved solutions to complex technical problems in health information management Ability to advise management and staff [on a wide range of health information management practices based on current industry standards - policies - statutes - laws - and regulations Ability to plan - justify - develop - evaluate - assess - monitor - and/or advise on current health information management processes - and recommend changes in policies or procedures Ability to determine and evaluate compliance with legal - ethical - and regulatory guidelines - and accrediting bodies as they apply to health information management. Ability to successfully apply principles and techniques of sound resource management (i.e. - staffing - space - contracts - equipment) Ability to provide the full range of supervisory duties to include assignment of work - completing performance evaluations - selection of staff - and recommendation of awards - advancements - and disciplinary actions AND Certification: Employees at this level must have a HIM Certification AND Demonstrated Knowledge - Skills - and Abilities: Ability to determine and evaluate compliance with legal - ethical - and regulatory guidelines and accrediting bodies - as they apply to health information management Ability to provide sound - technical guidance to staff at various levels about major program - legal - or procedural changes related to health information management Skill in revising facility policies and procedures to improve health information management services and to evaluate - modify - and/or adapt new methods to meet regulatory requirements Skill in analyzing complex data - interpreting - and trending results for effective management of the HIM program Skill in management/administration - which includes program planning - coordination - interpretation - supervision - consultation - negotiation - problem solving - and monitoring of HIM processes Ability to delegate authority - evaluate and oversee people and programs - accomplish program goals - and adapt to changing priorities Reference: For more information on this qualification standard - please visit The full performance level of this vacancy is GS-13 Physical Requirements: The physical requirements are typically light to sedentary They primarily involve prolonged periods of computer work - walking - lifting light items such as files - and standard office mobility. Duties The incumbent serves as the Chief - Health Information Management Section - Business Office provides expertise - guidance and direction and has responsibilities relative to providing supervision - administrative support - coordination - and technical assistance in the planning - development and maintenance of an effective - comprehensive - and integrated HIM Program at this Medical Center Major duties include - but are but not limited to: Provides technical and managerial expertise relative to health information management This includes recommendations regarding organizational structure - workflow - section policy - interpretation of section objectives - and methods of staffing within the section Implements recommendations and exercises immediate supervisory authority over the Coding Unit - File/ Scanning unit - and Release of Information Unit Has knowledge of statistics to assess patient workload and establish quality controls Evaluates Patient Treatment File (PTF) data validation program to include a qualitative review and evaluation of the clinical as well as administrative information reported into the PTF system with analysis and recommendations for corrective action Responsible for timely and complete submission of all quarterly census patients - and for the PTF abstracts which have a monthly close-out date with an annual hard close-out date for the fiscal year to the Austin Automation Center (AAC) National Patient Care Database (NPCD) Advises Medical Record Technicians (MRT) in problem areas about quantitative and qualitative analysis of medical records and determines acceptability of content Consults with physicians and other clinicians regarding record deficiencies as appropriate Coordinates and updates the Quality Management program for HIMS Joint Commission and VA standards require a quality management program - which includes medical record audits based on input from the Medical Records Committee - quality improvement staff and medical staff Audits will consist of review files Develops and maintains collaborative relationships with Physicians - Service Chiefs - and other medical center staff at all organizational levels Responsible for determining the need for and extent of training personnel outside HIMS regarding the medical records and its format May be required to develop training materials and continuing education programs Training programs developed and conducted by employee may include medical terminology - Evaluation and Management Code assignment - medical record documentation requirements - Release of Information - Privacy Act and HIPAA instructions Assistance is also provided in formal and informal service training and orientation of house staff as well as other members of the health care team regarding medical record functions and quality content Assist physicians and other health professionals in obtaining medical record information to be used in research projects Advises on what material is available - how it may be obtained and the uses that can be made of the information while protecting the confidentiality of the record Provides technical guidance to the unit supervisors and lead clerks while providing support of each unit in the absence of the section supervisor Provides expertise in subpoenas - court orders - advance directives - Privacy Act - Freedom of Information Act - and general release of information as well as other medical legal issues Work is of an analytical - evaluative - and creative nature - and incumbent responsible for keeping abreast of changes that are constantly being made in the health information field as well as allied medical fields and applying the information and knowledge gathered to the operations of the hospital Work Schedule: Monday - Friday 7:30am - 4:00pm Telework: Available Virtual: This is not a virtual position Functional Statement #: 688-25115-F Relocation/Recruitment Incentives: Authorized Permanent Change of Station (PCS): Not Authorized #J-18808-Ljbffr U.S. Department of Veterans Affairs