POSITION: DIRECTOR OF HEALTH INFORMATION MANAGEMENT
DEPARTMENT: HEALTH INFORMATION MANAGEMENT
FLSA STATUS: EXEMPT
JOB SUMMARY: Direct and manage the day-to-day activities of the Health Information Management Department that includes coding, chart analysis, document retrieval and release, and other duties related to management of Medical Records for the entire facility.
Responsible to the Chief Financial Officer
Positions Directly Supervised: Health Information Management personnel
Regular Contact with Providers, Director’s, Office Managers and personnel in other departments related to charging, coding and billing
As an integral part of our community, Franklin Medical Center’s mission is to provide the highest quality health care and customer satisfaction to all those we serve. We are committed to delivering compassionate, capable, and personalized treatment to our patients and their families, always keeping in mind that our responsibility is to the health needs of the people.
ESSENTIAL JOB FUNCTIONS:
Managing the Department
- Maintain current knowledge of HIM industry policies and practices with a goal of improving quality, efficiency and effectiveness of HIM activities.
- Maintain current knowledge of regulations and policies of State, Federal and private regulatory and surveying agencies regarding patient records to include record retention requirements, accuracy and completeness of records and coding guidelines.
- Participate in budgeting preparation process to insure HIM needs are met with efficient use of resources. Monitor budget on monthly basis to insure activities comply with plans, and communicate reasons for variances to CFO.
- Manage departmental staff, to include determine staffing levels, select, hire, evaluate, orientate, train, counsel and monitor job performance.
- Maintain systems and procedures to insure strict confidentiality concerning care and patient records at all times.
- Review and recommend internal policies to insure compliance with such laws, rules and regulations mentioned above.
- Prepare monthly, quarterly, annual and any special reports requested by CEO or CFO, and assure accurateness and timeliness of routine reports.
- Monitor overall discharged not final billed balance, compare to goal established by Administration, and report on any reasons for not meeting that goal.
- Attend training sessions and meetings, as required to maintain current knowledge of issues affecting Health Information Management.
Working with Medical Staff
- Communicates through written and verbal avenues with providers, committees, managers, subordinates, supervisors and employees about HIM rules, regulations and policies.
- Develop rapport with providers to be able to discuss delicate matters such as delinquent records.
- Attend routine Medical Staff meetings, and any special meetings as requested.
- Provide education as appropriate to assist Providers with efficient and complete documentation.
Working with Hospital departments
- Working with Hospital departments
- Coordinates with all departments in the implementation of interdepartmental system changes relative to the revenue cycle, including charging, coding, and payer policies through effective communication.
- Provides education to hospital staff, providers and their office staff on matters affecting completeness and accuracy of medical records and coding issues as necessary.
Other duties as assigned
- Develop internal monitoring and reporting systems for administration and providers.
- Serves as contact person to agencies having insurance payment contracts and is primary contact person for Medicare Program.
- Reviews denied claims and recommends policies and procedures to minimize denials. Corresponds with review organizations on behalf of physicians and facility on denials, quality issues and coding changes.
- Maintain quality indicators for HIM department and assist other departments with selection and reporting of quality indicators.
- Attends committee meetings as required or requested.
- Assists in medical care evaluation studies, as well as requests for special studies and reports utilizing information from patient records. Collects and records specific information and data needed to undertake such reports.
- Facilitates communication of all disciplines involved in the overall management of the DRG reimbursement system by serving as primary contact person for related information and concerns.
- Assists CEO and CFO in other duties as required and/or requested.
Education and Training: Minimum of Associate Degree in HIM and RHIT certification. Must have extensive education in ICD-9 and CPT-4 coding. Bachelor of Science degree in HIM and RHIA certification are preferred.
Work Experience: Minimum of 5 years working in Health Information Management department in a hospital. Must possess a solid background in all areas of HIM to be able to oversee the entire process. A thorough working knowledge of DRGs, ICD-9 and CPT-4 coding is necessary. Experience with government and insurance company reimbursement is required.
Knowledge, Skills, and Abilities: Must possess qualities of diplomacy and tact to maintain working relationships, and be able to establish rapport with physicians and other professionals. Must have ability to relate to hospital staff at all levels on a daily basis. Must be able to prioritize duties, and function independently and efficiently in completing tasks and duties with minimum supervision.
Physical Requirements: Must be able to hear and orally communicate both in person and by telephone in assuring the departmental functions are carried out. Must be able to communicate effectively in writing. Must have acceptable computer skills, including hospital information system, word processor and spreadsheet programs.
OSHA EXPOSURE CATEGORY: C – Not at risk for exposure to Blood Borne Pathogens.