Health Information Management Regulatory Analyst II

Eisenhower Health•Rancho Mirage, CA

1d•$26 - $40

About The Position

The Health Information Management Regulatory Analyst II is responsible for ongoing surveillance and maintenance of enterprise-wide Master Patient Indices and identity management across multiple source systems. The analyst serves as a subject matter expert for questions, training, and troubleshooting, and coordinates enterprise chart corrections and merges. The position coordinates regulatory workflows for patient requests for medical record amendments, including extensive communication with physicians, and supports HIM leadership with regulatory workflows such as release of information, survey activities, revenue cycle, and data management, including state reporting. The role also handles medical record reviews and investigations, supports birth registry quality assurance and submissions, assists with Epic MyChart and Care Everywhere workflows, and helps ensure compliance with applicable state and federal requirements. The analyst performs quality assurance, supports system testing and upgrades, develops training materials, and provides education and assistance to patients and HIM staff.

Requirements

Associate's degree in Health Information Technology, Health Information Management, or a related field.
Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) certification from the American Health Information Management Association (AHIMA).
Five years of experience in a health information management department in an integrated health system.
Ability to adapt quickly to changing priorities and unexpected situations.
Ability to collaborate and communicate with leadership, medical staff, colleagues, patients, regulatory representatives, and other third parties.
Ability to 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, medical record reviews, and investigation and troubleshooting of complex medical record issues across 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, merges, and 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 a high degree of accuracy.
Written and verbal communication skills.

Nice To Haves

Experience using Epic and OnBase.

Responsibilities

Demonstrate compliance with the Code of Conduct and compliance policies, resolve compliance questions or concerns, and report suspected violations.
Manage and coordinate regulatory workflows for patient requests for medical record amendments, including communication with physicians.
Collaborate with HIM leadership, Payer Relations, and Denials teams to investigate and process advanced document requests for ADR audits; coordinate release activities with the release-of-information vendor and verify completion within required timeframes.
Support regulatory survey activities by identifying and producing records and supporting compliance initiatives throughout the health system.
Work with HIM leadership and the Quality department to manage medical records and data for initiatives and data-validation activities.
Coordinate with the release-of-information vendor to support revenue-cycle denial and appeals activities.
Generate and work reports to maintain enterprise-wide Master Patient Index integrity and verify new medical record number assignments daily.
Resolve overlays and overlaps daily, coordinating with ancillary departments and clinics as appropriate; complete cancellation and transfer of accounts, episodes of care, and documents.
Manage medical records marked for merge and correction; review reports for duplicate MPI numbers and resolve duplicates daily.
Coordinate maintenance and testing of ancillary systems with responsible parties and participate in ADT and ancillary system testing related to merges and transfers.
Perform medical record reviews, investigate and troubleshoot issues across electronic platforms, and escalate complex issues to HIM leadership.
Assist HIM leadership with quality assurance review and validation of birth registry documentation before submission to the California Department of Vital Statistics.
Investigate birth registry issues and facilitate amendments as needed.
Validate birth registry data and documents and submit them to third-party regulatory agencies, including Social Security and the California Parentage Opportunity Program.
Assist HIM leadership with coordinating release-of-information activities.
Assist with Epic MyChart and Care Everywhere workflows within HIM's scope, including oversight and management of MyChart proxy authorizations, state reporting, and helping other healthcare organizations properly match patients in Care Everywhere.
Coordinate Advanced Health Care Directives and other legal documents; review them for compliance and processing in the electronic medical record system, and contact and educate patients about medical record management of planning documents.
Support the Privacy Code call center, assist patients, research and resolve issues, and escalate issues appropriately to HIM leadership.
Research regulatory issues and requirements and identify applicable state and federal requirements, including those concerning release of information and medical record amendments.
Work highly technical Epic and other system work queues to resolve issues and ensure accurate posting of patient information.
Perform quality assurance reviews of HIM workflows and report findings and recommendations to HIM leadership.
Serve as the HIM department subject matter expert for testing and validating system upgrades and implementing new workflows and technology.
Develop training tip sheets and help educate HIM staff on Epic and other regulatory workflows.
Provide ongoing patient education and assistance on HIM services.
Assist HIM leadership with coordinating MyChart Committee meetings, communications, and related activities.
Attend and participate in meetings related to the scope of work.
Perform other duties as assigned.