HIM SPECIALIST

Duke Careers•Durham, NC

24d

About The Position

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Occ Summary Independently performs specialized or advanced health information activities necessary to organize, maintain, and use electronic patient health records. Activities required include research, analysis and compilation of findings into summarized reports that will be shared within and external to the Health Information Management Department. Positions at this level have high customer service, strong analytic and problem solving skills, require interpretation and explanation of policy and external requirements related to, privacy, release of information, positive patient identity, and other department and organization-wide functions. Specific job responsibilities are based on the service unit within Health InformationManagement assigned. Expert computer skills to navigate and query multiple electronic record systems. Release of Information: regular interaction required with patients, attorneys, and governmental agencies, providers of health care, insurance companies,auditing agencies, and researchers. Detailed working knowledge and ability to apply HIPAA rules, North Carolina General Statutes, and other State and Federal laws regarding patient privacy. Patient Identity Management: regular interactions required with patients, attorneys, insurance companies, providers of healthcare and governmental agencies. Detailed working knowledge and ability to apply State and Federal laws regarding positive patient identification, identity theft, vital records regulations, JointCommission requirements, and CMS guidelines and rules.

Requirements

Good organizational skills, excellent investigative/analytic skills with detail orientation, and strong follow-through capabilities.
Excellent verbal and written communication skills in order to effectively problem-solve, develop working relationships, and assist system users.
Must be able to meet deadlines, work independently, set priorities, and maintain confidentiality.
Ability to work calmly and efficiently in high-pressure situations.
Intermediate to expert skills using Windows-based software and familiarity with information technology hardware and software in a local and wide area network environment.
High School Diploma required; Associate's degree in health information management or related field preferred
Four years of experience in a health care-related field required, two of which must be in health information management. Candidates with an Associate's degree in HIM require two years of Health Care experience and one year of HIM-specific experience; candidates with a Bachelor's degree in HIM require two years of health care experience; and candidates with a Bachelor's degree in Health Care require two years of HIM-specific experience

Nice To Haves

Intermediate knowledge of human anatomy and physiology and medical terminology is highly preferred.
RHIT/RHIA/CHPS/CHDA

Responsibilities

Release of Information Functions: Review request for medical records to identify dates of service, entity, provider and specific clinical documents requested. Works extensively in the electronic health record and de-centralized electronic databases to locate specific clinical documents for the purpose of fulfilling a request. Reviews patient authorizations to validate HIPAA required elements and validate legal authority of requestor. Reviews NC and Out of State Subpoenas and Court Orders to determine if valid and returns to requestor if deemed invalid. Coordinates visits from Health Plan Reviewers and Research Monitors through provision of electronic medical records, assignment of passwords and deactivates passwords at conclusion of visit. Assists reviewer in locating specific documents as needed. Reviews requests for patient amendments, locates disputed documents in the electronic health record and notifies provider of patient request for amendment. Tracks amendment request to ensure patient is notified of outcome within HIPAA required timeframe. Obtains Itemized Statements from PRMO Self Pay and uses to calculate lien balances and generate AttorneyLien letter and forwards Itemized Statement to requestor as needed. Obtains provider approval to release psychiatric encounter records when requested by the patient and seeks provider approval to release records for minor patients ages 12-17 to parent to comply with additional privacy protections under NC Statute and Federal Law. Accompanies certified copies or original health records to the court and location of scheduled depositions when required. Testifies in court and depositions as to the authenticity of health records containing PHI.
Patient Identity Management Functions: Track, monitor, and validate patient overlays that occur during patient registration and scheduling activities. Analyze and trend data for feedback to the appropriate department. Notifies compliance and affected departments of incorrect documentation location. Coordinates Chart Correction Cases within Maestro Care, including evaluation of help desk requests, assignment of correction tasks and verification completion and closure of the case and verifies completion and closure of the case. Maintains an accurate Enterprise Master Patient Index (EMPI) through active research and comparison of potential duplicates and clinical history to resolve patient identification discrepancies, including necessary investigation of potential identity theft. Performs name and demographic changes with supporting documentation. Performs concurrent and retrospective contact moves. Analyzes the content of the health record document and coordinates with responsible providers, clinicians, and ancillary departments participating in the patient's care for record correction requirements to resolution. Leads clinical, ancillary, and financial staff to assist in resolving overlay issues of multiple patient information in one medical record to resolve overlay within 24 hours of discovery of overlay.
Participates in a 24-hour on-call rotation. Maintains enterprise master patient index integrity medical record number merges, un-merges, and medical record number assignments electronically. Performs name and demographic changes with supporting documentation. Works with management to compile and review trending reports for patient identity functions. Assists with the preparation of procedure documentation to support processes and training. Performs other duties as assigned, including customer service focus in training providers and internal and external customers on chart correction/support ticket resolution.

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