Health Information Management (HIM) Manager - Onsite

ClearSky Health•Mansfield, TX

4d•Onsite

About The Position

The HIM Manager maintains the security, confidentiality, completeness, and accuracy of medical records in accordance with organizational policies and regulatory guidelines. The role may also serve as the Hospital’s Privacy Officer and oversees compliance efforts related to the Centers for Medicare & Medicaid Services (CMS) Review Choice Demonstration (RCD) and Final Rule Audit (FRA), serving as the primary onsite contact for related initiatives. The position integrates company values into daily practice. The HIM Manager directs and participates in day-to-day HIM department activities, including indexing, transcription, quantitative analysis, chart completion, release of medical record information, and abstracting medical information. The manager oversees concurrent record completion, works across disciplines to promote accuracy and Final Rule adherence, supports providers using Cerner, and serves as a Cerner superuser and source expert in auditing Final Rule elements. The role monitors staff and physician compliance with recordkeeping requirements and collaborates on documentation and timeliness improvement and education. The position oversees the development, implementation, maintenance, and adherence to information privacy policies and procedures in coordination with Hospital administration, the Corporate Compliance Officer, and legal counsel. It safeguards medical-record confidentiality, ensures the Release of Information policy is followed, secures legal and risk-management records, responds to subpoenas and court orders, and may represent the Hospital in court hearings or depositions. The manager may also perform initial and ongoing credentialing for Hospital medical staff. Once the Hospital is formally under RCD, the manager follows protocols for Medicare affirmations and timely responses to non-affirmations, stays informed about RCD/FRA process changes and regional MAC approaches, communicates non-affirmation or denial reasons to leadership, assists with justifications and appeals, synthesizes clinical documentation to support services for all payors, and maintains tracking systems for deadlines and real-time admission data. The role also supports a safe environment, follows safety and Infection Prevention standards, completes assigned training, and performs other duties as assigned.

Requirements

Two years of medical records experience.
A degree in Health Information Management or a related subject.
Knowledge of information privacy laws, including 45 CFR, HIPAA, and state medical-records law.
Working knowledge of general hospital operations.
Knowledge of accreditation standards and requirements set by state agencies, TJC, and CMS.
Understanding of treatment costs and financial support as they relate to quality and efficiency.
Working knowledge of medical terminology, abbreviations, and spelling.
Ability to maintain exceptional confidentiality.
Proficiency with general computer skills, including data entry, word processing, email, and records management.
Critical-thinking skills.
Ability to prioritize, meet deadlines, and complete complex tasks.
Ability to maintain quality and safety standards.
Ability to work professionally with people at all levels of the organization.
Effective organizational and time-management skills.
Ability to travel as needed.
Physical ability to sit, walk, bend, reach, lift, and carry, often for prolonged periods; exert or lift up to 10 lbs; operate equipment and a computer keyboard; focus at close vision; and hear overhead pages.

Nice To Haves

Two years of medical coding experience.
Experience in a management role.
A degree from a CAHIIM-accredited program.
RHIA or RHIT certification.
CCS certification as an additional credential.

Responsibilities

Direct, plan, schedule, and participate in day-to-day HIM department activities, including indexing, transcription, quantitative analysis, chart completion, release of medical record information, and abstracting medical information.
Oversee daily concurrent medical record completion and collaborate across disciplines to promote accuracy and adherence to the Final Rule.
Act as Cerner superuser and source expert in auditing Final Rule elements, and support providers using Cerner.
Direct record assembly and review medical records for data elements required for chart completion.
Monitor and evaluate physicians and hospital staff for compliance with recordkeeping requirements.
Oversee activities related to the development, implementation, maintenance, and adherence to information privacy policies and procedures.
Provide guidance and assist with identifying, implementing, and maintaining information privacy policies and procedures in coordination with Hospital administration, the Corporate Compliance Officer, and legal counsel.
Safeguard medical-record confidentiality by ensuring compliance with the Release of Information policy and applicable requirements; secure legal and risk-management records; respond timely to subpoenas and court orders; and represent the Hospital in hearings or depositions as required.
Collaborate with RCD leadership and hospital staff on process improvement and education regarding documentation and timeliness.
May perform initial and ongoing credentialing for Hospital medical staff.
For a Hospital formally under RCD, follow protocols for Medicare affirmations and timely responses to non-affirmations.
Stay informed about changes in RCD/FRA processes, including regional MAC approaches and review outcomes.
Communicate reasons for admission non-affirmations or denials to Hospital and RCD leadership and assist with necessary justifications.
Assist as directed with denials through the appeal process and synthesize clinical documentation to justify services for all payors.
Manage tracking systems to meet deadlines and provide real-time data on new admissions for timely submissions.
Provide an environment conducive to safety, assess safety risks, and implement appropriate precautions.
Comply with approved safety and Infection Prevention standards and complete assigned required training.
Perform other duties as assigned to support organizational effectiveness.