HIM Operations Specialist II

Advocate Health and Hospitals Corporation•Charlotte, NC

21h•Onsite

About The Position

This full-time position in Enterprise Revenue Cycle - HIM Ops Document Management is responsible for applying knowledge of medical terminology and nomenclature to accurately analyze and identify documentation needs based on services provided and coding queries. The role involves accurately classifying clinical documentation, assigning, editing, and tracking medical record deficiencies by responsible provider into the chart management system to support patient care, coding, and revenue cycle. Responsibilities include reviewing, uploading, and processing Health Maintenance results and Advance Care Planning Directives, reviewing clinical documentation for Diabetic Retinopathy, and performing HIM and coding support functions to meet established metrics and KPIs. The specialist will obtain and import documentation from various sources to support accurate coding and billing, ensure compliance with regulations, and use critical thinking to identify and escalate workflow issues. Collaboration with various departments is expected to resolve issues. The role also involves validating deficiencies, notifying clinicians about incomplete documentation, and performing specialized workflows for presurgical H&Ps and other documents. The specialist will incorporate clinical documentation from diverse sources into the EHR, meeting established benchmarks for quality, accuracy, and productivity, and will coordinate support activities and provide training for Epic Connect clinics transitioning to EPIC.

Requirements

High School Diploma or GED Equivalent
Typically requires 1 to 2 years of experience in healthcare.
Ability to work independently and make decisions with minimal supervision using critical thinking skills, while maintaining quality and productivity standards.
Demonstrates effective problem identification, problem solving and priority setting skills.
Proficient computer and keyboarding skills with the ability to learn new computer software systems such as Epic, OnBase, Solarity, Microsoft Office, and legacy archives, and electronic communication and meeting platforms such as Teams.
High attention to detail and accuracy with the ability to limit interruptions.
Ability to prioritize workload and work under pressure in a fast-paced environment with time constraints.
Works collaboratively in a diverse team environment with openness and respect to learn, create and problem-solve.
Ability to adapt to a fast-paced environment and transition to switching tasks without issue while maintaining quality and accuracy.
Ability to learn when receiving constructive feedback by leadership or peers and taking personal ownership for success.
Strong interpersonal, written, and verbal communication skills.
Ability to safeguard protected health information (PHI) and possess basic knowledge of HIPAA.

Responsibilities

Applies knowledge of medical terminology and nomenclature to accurately analyze and identify documentation needs based on services provided and coding queries.
Accurately classifies clinical documentation for all tests, treatments, procedures, and other services.
Assigns, edits, and tracks medical record deficiencies by responsible provider into the chart management system accurately and timely to support continuity of patient care, coding, and revenue cycle.
Reviews, uploads, and processes to Epic, Health Maintenance results and Advance Care Planning Directives based on state guidelines according to procedures.
Reviews clinical documentation for evidence of Diabetic Retinopathy, abstracting components to support Health Maintenance initiatives.
Performs HIM and coding support functions as assigned, positively contributing to established metrics, key performance indicators, and turn-around-times.
Obtains and imports documentation from internal and external sources to justify and support accurate coding and billing for services performed by employed clinicians.
Ensures compliance with all organizational policies and procedures, Medical Staff Bylaws, and State and Federal regulations, such as The Joint Commission (TJC), Det Norski Veritas (DNV) and Centers for Medicare and Medicaid (CMS).
Uses critical thinking to identify and escalate front end or system workflow issues.
Collaborates with department leaders, clinical informatics, IT, coding and HIM Optimization to problem-solve and resolve the identified issues.
Validates deficiencies and chart completion status in the electronic health record (EHR) to support reporting of incomplete and delinquent medical record documentation.
Accurately notifies clinicians regarding incomplete documentation and informs leadership regarding accountability sanctions.
Performs specialized workflows to verify the validity of presurgical H&Ps and other documents received via OnBase work queue and upload to the EHR.
Incorporates internal and external clinical documentation from various electronic and paper sources via applicable software work queues, rounding, eDelivery or importing into the EHR routing to the clinician as appropriate according to HIM procedures while meeting established benchmarks for quality, accuracy, and productivity.
Coordinates all support activities, provides training and education to Epic Connect clinics for transition to EPIC.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program