Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve.

The HIM Manager is responsible for maintaining the security, confidentiality, completeness, and accuracy of medical records in accordance with policies and procedures and within the guidelines of regulatory agencies. The HIM Manager may also act as Privacy Officer for the Hospital. Oversees compliance efforts related to the Centers for Medicare & Medicaid Services (CMS) Review Choice Demonstration (RCD) and the Final Rule Audit (FRA). Serves as the primary onsite contact for all RCD/FRA compliance initiatives. This position must integrate company values into daily practice.

Essential Functions:

• Directs, plans, schedules, and participates in day-to-day activities within HIM department, including , indexing, transcription, quantitative analysis, chart completion, the release of medical record information and abstracting of medical information.
• Oversee daily concurrent medical record completion, collaborating across all disciplines to ensure 100% accuracy and adherence to the Final Rule.
• Acts as Cerner superuser and source expert in auditing Final Rule elements. Supports providers using Cerner.
• Directs record assembly and reviews medical records for data elements required for chart completion.  Monitors and evaluate physicians and hospital staff to ensure compliance with record keeping requirements.
• Oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization’s policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and the healthcare organization’s information privacy practices.
• Monitors and evaluates physicians and hospital staff to ensure compliance with record keeping requirements. Collaborates with RCD Leadership and hospital staff on process improvement and education regarding documentation and timeliness.  
• Provides development guidance and assists in the identification, implementation, and maintenance of organization information privacy policies and procedures in coordination with Hospital administration, Corporate Compliance Officer, and legal counsel.
• May perform initial and ongoing credentialing for Hospital medical staff.
• Safeguards the confidentiality of all medical records by ensuring the Release of Information policy is followed in accordance with HIPAA and other requirements; securing legal/risk management records; responding timely to subpoenas and/or court orders; and representing the hospital in court hearings and/or depositions as required.
• Provides an environment conducive to safety for patients, visitors, and staff. Assesses the risks for safety and implements appropriate precautions. Complies with appropriate and approved safety and Infection Prevention standards.
• Performs other duties as assigned to support overall effectiveness of the organization.

Once the HIM’s hospital is formally under Review Choice Demonstration, the following will be incorporated into day-to-day duties:

• Follow established protocols to facilitate Medicare affirmations and respond timely to non-affirmations under the Review Choice Demonstration process.
• Stay informed about changes in RCD/FRA processes, including regional Medicare Administrative Contractor (MAC) approaches and review outcomes.
• Communicate reasons for admission non-affirmations/denials with hospital leadership and RCD leadership and assist in providing necessary justifications.
• Assists as directed with denials through the appeal process. Includes synthesizing clinical documentation for each patient’s stay into justification for services for all payors.
• Manage tracking systems to ensure deadlines are met and real-time data on new admissions is available for timely submissions.
   

Minimum Job Requirements 

Minimum Education & Experience: 

• Two years medical records experience required
• Two years of medical coding experience preferred.
• Degree in Health Information Management preferred.
• Experience in a management role preferred.

Required Licenses, Certifications, and/or Documentation:

• RHIA or RHIT certification required.
• CCS preferred as additional credential.
• Must maintain acceptable driving record, current driver’s license, and insurability.

Required Knowledge, Skills, and Abilities:

• Demonstrates knowledge in information privacy laws including 45 CFR, Health Insurance Portability and Accountability Act (HIPAA), and state medical records law.
• Demonstrates a clear working knowledge of general hospital operations.
• Knowledge of accreditation standards to ensure adherence to all standards set forth by state and accrediting agencies of TJC and CMS.
• Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency.
• Working knowledge of medical terminology, abbreviation, and spelling.
• Ability to maintain exceptional levels of confidentiality.
• Demonstrates proficiency with general computer skills including data entry, word processing, email, and records management.
• Demonstrates critical thinking skills.
• Ability to prioritize, meet deadlines, and complete complex tasks.
• Ability to maintain quality and safety standards.
• Ability to work closely and professionally with others at all levels of the organization.
• Effective organizational and time management skills.

Physical Requirements Over the Course of a Shift:

• A significant amount of sitting, walking, bending, reaching, lifting, and carrying, often for prolonged periods of time.
• Lifting/exerting of up to 10 lbs.
• Sufficient manual dexterity to operate equipment and computer keyboard.
• Close vision and the ability to adjust focus.
• Ability to hear overhead pages.