Medical Records Technician II- CMHHIP

State of Colorado•Pueblo, CO

8d•Onsite

About The Position

This position is 100% on campus, Monday - Friday, with hours from 8:00 am - 5:00 pm. The primary responsibility is HIPAA risk assessment, investigation, and data tracking. This role abstracts data from charts for reporting to The Joint Commission, CMS, and ORYX. It also provides back-up for utilization review and other duties as needed within the Medical Records Department. The Medical Records Department manages health information for CMHIP, a psychiatric hospital serving the mentally ill. Responsibilities include scanning documents into the electronic Medical Record (BEHR), monitoring BEHR for completeness and accuracy, completing daily census reports, and providing diagnostic codes for reimbursement. Medical records are audited, coded, and abstracted. The department also retrieves legacy records, protects health information confidentiality, and responds to record requests, all while providing professional and positive customer service to enhance working relationships and team performance.

Requirements

Two years (2) of Medical Records Experience in a hospital setting managing the HIPAA process OR A combination of related education in Information Management or certification in HIPAA, and/or relevant experience in a hospital equal to two (2) years.
Ability to read and comprehend the English language.
Effectively and fluently communicate in English, both verbally and in writing.

Nice To Haves

Substantial experience with HIPAA processes.
Preferred experience with utilization review, e.g., obtaining prior authorizations.
Relevant years of state service experience.

Responsibilities

Perform HIPAA risk assessments, investigations, and data tracking.
Abstract data from charts for reporting to The Joint Commission, CMS, and ORYX.
Provide back-up for utilization review and other Medical Records Technician III duties.
File all records using the terminal digit filing system.
Manage the Medical Records File room, including moving records and boxing death charts.
Scan documents into the electronic Health Record (BEHR), ensuring accuracy and correct patient/episode/folder.
Maintain Standard Operating Procedures for scanning and abstracting.
Retrieve paper charts from storage for readmissions.
Answer incoming phone calls and release patient information for continuity of care per HIPAA regulations.
Process pre-release packets for Social Security and Medicaid benefits.
Review and update policies every two years or after HIPAA regulation changes.
Complete initial audits of buildings using the Environment of Care Audit Tool and assess recommendations for HIPAA compliance.
Work with Staff Education to assign HIPAA training and follow up on identified HIPAA violations.
Complete Annual Risk Assessment and prepare monthly HIPAA reminders for the CMHIP campus.
Report all HIPAA violations and breaches to the HIPAA Officer and Division Management.
Mitigate Security and Privacy breaches and/or incidents with the HIPAA Officer and management.
Report IT security incidents to the help desk.
Interview staff related to HIPAA violations and determine if PHI was compromised.
Notify clients of potential privacy or security risks to their data and document incidents.
Participate in CDHS HIPAA Steering Committee meetings.
Keep HIPAA on-line training presentation up-to-date and provide periodic HIPAA training.
Monitor encryption of mobile device usage and facilitate the appropriate use of Business Associate Agreements, MOUs & MOAs.
Determine the type of authorization required per HIPAA Federal Regulations for releasing patient information.
Allow inspection of records and provide copies.
Release information to authorized requesters by law, with or without patient consent.
Maintain release of information log and document all information released into the Release of Information database.
Determine costs of copies and send billing statements to requesters.
Update release of information log when payments are received and forward payments to General Accounting.
Locate and retrieve records from various storage areas.
Forward patient phone calls or refer requesters to proper individuals.
Complete audits for ECT, admissions, concurrent, outpatient, discharges, and deaths for compliance.
Enter deficiencies in BEHR for Providers and in the Outstanding Errors spreadsheet.
Run the “Saved not Signed” report and notify staff of documents needing signature.
Track Initial Plans of Care and subsequent Treatment Plan Reviews.
Keep a record of due dates for RN annual assessments, and Social Work and Psychiatric biannual assessments, and send reminders.
Send “Saved, not Signed” and Therapeutic documentation deficiencies to individuals monthly.
Request death certificates for deceased patients.
Abstract data for HBIPS core measures, ensuring accuracy for admissions and discharges.
Verify all admissions and discharges are entered into BEHR.
Scan SP1’s and signature pages.
Request and obtain all authorizations for third party payer insurance reimbursement based on medical necessity.
Maintain a current contact list for each insurance carrier and relevant departments.
Submit appropriate medical record documentation to third party payers.
Perform follow-up for lack of response from third party payers.
Problem-solve issues in the authorization request process.
Maintain a tracking tool for authorization requests.
Report current authorization information or concerns to the Utilization Review Manager weekly.
Schedule clinical consultation meetings for provider/clinical team members with insurance representatives.
Perform assigned tasks and duties within the scope of practice to meet agency and department goals.