Health Information Management (HIM) Technician (Santa Rosa)

Starting Rate : $25 KEY RESPONSIBILITIES :

• Run daily AIS reports to validate and account for patient discharges, both Inpatient and Outpatient.
• Pull charts for review and analysis on a timely basis as required by policy and by regulation.
• Assemble and analyze discharged patient charts and review Inpatient and Outpatient records according to department standards.
• Responsible for managing patient health records.
• Identify chart deficiencies for missing details (i.e., Protected Health Information, signatures, dates, times, and details) and charting.
• Document deficiency findings using the deficiency tools in software and on corresponding audit forms.
• Enter deficiencies into AIS.
• When charts have been completed by the physician or midlevel, reanalyze the pt charts for accuracy and remove deficiencies from AIS accordingly.
• Create and maintain patient charts based on established department guidelines.
• Ensures medical records are assembled in standard order and are accurate and complete.
• Assist in retrieving charts for stakeholders for chart completion.
• Retrieve and re-file the patient’s medical records, as needed.
• File loose filing daily into the proper charts. Prepare charts for patient discharge process.
• Creates or scans digital images of photos, forms or records to be included in the electronic medical record.
• Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them accurately, timely, and appropriately.
• Process all requests for medical records received by mail, fax, or phone according to State and Federal requirements.
• Ensure that the release of information is completed properly, timely, and valid.
• Collaborate with other departments to gather records needed to ensure timely and compliant billing.
• Assist in answering telephone and taking accurate messages.
• Pulling charts for physicians, nursing and other hospital personnel.
• Perform audits as requested.
• Assist in processing dictated and / or transcribed reports.
• Print reports as needed for timely inclusion into the patient’s active medical record.
• Work with the physicians, midlevels, and other hospital personnel to answer questions regarding dictation or transcription.
• Ensures that errors by outsourced transcription company are corrected and sent to the document’s author for review and signature.

Requirements

Knowledge and Experience :

• High school diploma or equivalent.
• One year of experience working with medical records preferred.
• Coursework specific to regulations pertaining to proper administration of medical records preferred.
• Demonstrated knowledge of patient privacy and security, HIPAA, CMIA, and LPS relative to maintaining medical records required.
• Knowledge of medical terminology preferred.

Skills and Abilities :

• Promote patient, physician, customer and employee satisfaction by personal example, treating all contacts with respect
• Support and participate in activities that foster customer service
• Communicate and follow the organizational chain of command for notification of patient care / service issues, when appropriate
• Maintain a complete knowledge base of record completion requirements
• Maintain consistent productivity and quality of work in a challenging, fast paced and rapidly changing environment
• Closely adhere to set schedules and timecard procedures
• Identify, resolve and escalate major issues and service failures that impede success
• Maintain confidentiality of all patient demographic, medical, and financial information, ensuring proper handling and disposal of confidential documents and adherence to HIPAA
• Comply with all applicable Federal, State, and local laws, regulations, and requirements as well as PH&S policies and procedures in all aspects of job performance
• Attend and successfully completes general and department orientation, in-service programs and the annual key competencies and mandatory update requirements
• Participate actively in department staff meetings
• Demonstrate effective verbal and written communications
• Communicate effectively in all interactions in a clear, concise, understandable manner.
• Actively seeks constructive feedback and remains open and receptive to it
• Anticipate the information needs of others
• Demonstrate competency by maintaining positive, constructive interpersonal relationships, and by understanding and practicing the principles of effective teamwork
• Take responsibility to support team members in meeting project milestones and objectives.
• Perform challenging tasks efficiently and effectively
• Show strong, meticulous attention to detail and excellent analytical skills
• Demonstrate performance by adhering to established policies and procedure and exhibiting the defined characteristics associated with attendance and punctuality
• Monitor work queues and perform problem resolution / corrective action where needed
• Analyze medical records for completeness and compliance
• Assign documentation deficiencies to the correct physician, nursing, or other hospital personnel
• Process, scan and index medical records for accuracy, completeness and compliance into the correct paper or electronic medical record
• Confirm authorizations for release of information for requests as necessary
• Respond to business office requests for information and copies of specified documents

Physical Requirements :

While performing the duties of this job, this position is frequently required to do the following :

• Use standard office equipment and access, input, and retrieve information from a computer. Use computer keyboard with manual and finger dexterity and wrist-finger speed sufficient to perform repetitive actions efficiently for extended periods of time.
• Communicate effectively in person or via telephone in a manner which can be understood by those with whom the person is speaking, including a diverse population.
• Frequent bending, squatting, kneeling, climbing with the use of a step stool and twisting. Lift and carry up to 20 pounds.
• Sit or stand for minimum periods of one hour at a time. Come and go from the work area repeatedly throughout the day.
• Give and follow verbal and written instructions with attention to detail and accuracy.
• Perform complex mental functions and basic arithmetic functions; interpret complex laws, regulations, and policies; collect, interpret, and / or analyze complex data and information.
• Vision : see details of objects at close range.
• Coordinate multiple tasks simultaneously.

Benefits

Medical

Vision

Dental

401(k)

3.5 Weeks Paid Time Off

$25,000 Life insurance policy is provided at no charge to the employee