Title HIM (Health Information Management) Technician II ^60099
Req Number 12-03377
Open Date 12/12/2012
Analyzes, abstracts, and reviews, inpatient, same day surgery, emergency room, Chestnut Ridge inpatient and observation charts to ensure completeness for billing, TJC, Corporate Compliance Plan, HCFA documentation requirements, WVMI, ACOS, and other accrediting agencies and third party providers. Responsible to ensure proper validation and authorization for requests for release of protected health information from WVUH properties in various media formats. Responsible to ensures proper document capture and documentation correction for protected health information in all hospital systems as appropriate.
Essential Duties and Responsibilities: include the following. Other duties may be assigned.
1. Analysis of inpatient, same day surgery, emergency room, Chestnut Ridge inpatient and observation charts to ensure completeness for billing, TJC, Corporate Compliance Plan,
HCFA, ACOS, WVUH Bylaws and Rules and Regulations, as well as UHA guidelines, and other accrediting agencies.
1.1 Analysis of all charts inpatient, same day surgery, emergency room, Chestnut Ridge inpatient and observation by reviewing all pertinent data, identifying incomplete documentation for billing, TJC, Corporate Compliance, HCFA, ACOS, WVUH Bylaws, Rules and Regulations, UHA and other accrediting agencies. Determines the responsible staff, assigns deficiencies to resident and staff physicians for completeness. Standard rate of twelve (12) charts analyzed per hour for inpatient, SDC thirty-five (35) charts analyzed per hour, and OBS twenty-two (22) charts analyzed per hour..
1.2 Assigns deficiencies for each deficiency type by physician in Horizon Patient Folder and Merlin.
1.3 Analysis of all charts for orders and other printed documentation,
identifying deficiency for required signatures, dates and times.
1.4 Reviews and assigns undictated Discharge Summaries, Operation Reports, and Catheterization Reports in a timely fashion.
- Monitors and generates reports for all deficiency and suspension data, reporting to the Vice President of Medical Staff Affairs, Health Information Management Director and Health Information Management Manager of Technicians in order to comply with TJC Delinquency Rates, Corporate Compliance Plan, HCFA, Hospital Bylaws and Rules and Regulations.
2.1 Updates all data as necessary for timely and accurate reporting, for example: completed deficiencies, reassignment of deficiencies, and physician absences when notified.
2.2 Produces reports for suspension of physician privileges, unbilled accounts, statistical analysis for TJC, reports for hospital administration,
committees, and productivity reports.
2.3 Works to ensure the completion of dictated reports and maintenance of accurate
undictated lists. Ability to scan the dictation system as needed to verify completion of dictation deficiencies.
- Communications with the Medical Staff to ensure accurate and timely completion of all deficient charts and documentation for TJC, Corporate Compliance Plan, ACOS, HCFA, WVUH Bylaws Rules and Regulations, and UHA requirements.
3.1 Utilizes all communication mediums; paging, e-mail, voice mail, and facsimile, to notify physicians of undictated documentation, chart deficiencies, timelines for completion, and suspension status as appropriate.
3.2 Responses to all physician requests navigating HPF, assisting physicians with completion of documentation, and answering minor questions regarding coding and DRG’s, Hospital Bylaws Rules and Regulations issues, TJC, ACOS TNM Staging forms, and other reimbursement issues. Problem responses will be referred to the appropriate Manager.
3.3 Prepares reports of all delinquent charts and physicians that are eligible for suspension. Verifies correctness of the data, updating as necessary.
3.4 Prepares and distributes suspension notices via email to Vice-President of Medical Staff Affairs, notifies HIM Manager of Technicians, HIM Director of pending suspensions.
4. Completion of TJC Record Analysis and other review activities.
4.1 Participates on the TJC Continuous Record Review Team, completing analysis of the records.
4.2 Completes the forms for TJC Closed and Open Record Review, submitting finding to the HIM Management.
4.3 Assists with other review activities.
- Completion of Registry Audits in coordination with Medical Staff Affairs and Nursing Services for certification accreditations.
5.1 Responsible for abstraction of TJC data elements for Restraint compliance and enter abstracted criteria into database for restraint audits.
5.2 Responsible for other audits as assigned, for TJC IM Standard Compliance such as H&P, Legibility, etc.
- Completion of abstraction of data for TJC Stroke Certification Accreditation and WVUH Stroke Registry.
6.1 Abstracts data for all treated stroke patients at WVUH for appropriateness and timeliness of care.
6.2 Submits abstracted data to Medical Staff Affairs for reporting to TJC and other accrediting agencies as appropriate.
6.3 Maintains knowledge base of definitions of strokes, treatable conditions, and the appropriate process of care for stroke diagnosed patients,
and knowledge of documentation abstraction skills.
- Completion of abstraction of data for WVMI 7th Scope of Work focus areas.
7.1 Abstracts data for patients meeting 7th Scope of Work focus areas:
a) Acute Myocardial Infarction (AMI)
b) Congestive Heart Failure (CHF)
d) Surgical Infection Procedures (SIP)
7.2 Enters data into Access Database for Medical Staff Affairs for statistical compilation, data reporting, and compliance of participation in
7th Scope of Work.
7.3 Maintains knowledge base of diagnoses, treatment and abstraction data for all 7th Scope of Work focus areas:
a) Acute Myocardial Infarction (AMI)
b) Congestive Heart Failure (CHF)
d) Surgical Infection Procedures (SIP)
- Performs specific system maintenance on the Deficiency Analysis Network in Horizon Patient Folder.
8.1 Responsible for compiling and generating reports for medical staff credentialing, statistical information, and compliance for TJC, Corporate
Compliance Plan, and HCFA requirements.
8.2 Maintains up-to-date definition tables in the deficiency analysis program, updating regularly any changes in medical staff personnel, and
8.3 Performs other network system maintenance as necessary and appropriate, including software manual upgrades and testing, modifications,
and network problems. Notifies IT Help desk when problems arise for correction.
9 Perform software and scanner maintenance setup daily by work assignment.
9.1 Initiate and activate scanner by using Microsoft Windows daily.
9.2 Assess and evaluate scanner set-up properties based on work assignments.
9.3 Must understand the difference between feeder and flatbed adjustments.
9.4 Reset scanner based on specific work assignment (i.e. colored documents).
9.5 Performs daily maintenance (i.e. paper jams) and weekly cleaning of scanners.
10 Communication / Confidentiality
10.1 Communicates clearly and effectively both orally and in writing to a variety of customers and end-users.
10.2 Maintains patient confidentiality by not revealing and/or discussing patient information with anyone who does not have a legitimate interest in the
10.3 Observes attorneys, patients, et al, reviewing records as necessary, responding to questions with regard to maintenance of Protected Health
10.4 Monitors faxing and printing of patient records to ensure legitimacy and accuracy when necessary.
10.5 Uses good judgment and discretion when dealing with physician offices concerning access to and availability of records.
10.6 Works as a team member with Management, co-workers, and other departments.
11 Scans and indexes medical records for optical imaging and routes finished documents to appropriate areas.
11.1. Selects appropriate imaging cabinet based on assignment.
11.2. Scans documents by placing in optical scanning equipment.
11.3. Downloads data in existing digital format when necessary.
11.4 Indexes documents with patient identifying information as determined.
11.5 Loads scanner with documents based on size, color, type, etc.
11.6 Assure that documents meet quality standards and accept or reject.
11.7 Re-scans documents when necessary to ensure clarity and accuracy.
11.8 Utilizes windows technology to select drop down boxes.
12 Assume primary responsibility for the correction of duplicate patient registrations (duplicate CPI).
12.1 Monitor reports and analyzes reports duplicate number assignment to identify most appropriate number to utilize.
12.2 Requests patient record and/ or microfilm as necessary, combining all patient records, re-numbering and re-assembling the permanent record appropriately.
12.3 Assumes responsibility for timely, accurate combination of accounts in the Patient Management and TDS information systems.
12.4 Facilitates correction of double numbers throughout all inpatient and outpatient information systems to include, but not be limited to: Merlin, UHA(IDX),
Clinical Laboratories (Sunquest), Radiology, Pathology, Family Medicine, Decision Support, POC Medical Records, Utilization Management, Patient
Access, Information Technology, Patient Accounting, Cancer Center, Cardiology, Medsite, WSSRD and Medical Transcription Departments.
12.5 Concurrently monitors origination points of duplicate number assignments, reporting same to appropriate registration area for educational use.
12.6 Collaborates daily with the following persons to ensure integrity of data throughout the four critical information systems: Supervisor, UHA
Reimbursement (IDX); Manager, Enterprise Applications (TDS); Supervisory, Laboratory Information Services (Sunquest); and User Support Specialist
13 Insures proper release of information on all requests for medical information in a timely manner from all WVUH properties in various media formats.
13.1 Ensures that each request is validated in compliance with HIPAA guidelines and State/Federal Regulations. (i.e., patient name & date of birth, who to
release to, from who, and specific items to be released)/
13.2 Verify supporting documents for patient representatives such as Power of attorney, healthcare surrogate or other legal representation.
13.3 Comparison of signature of the requestor with signature on file.
13.4 Maintains release log of all PHI requests using appropriate systems.
13.5 Handles all incoming PHI requests, providing in accepted medium of the requested medical information.
13.6 Provides complete and accurate medical records for review by lawyers, outside agencies and/or third party payors.
13.7 Provides radiology imaging through ROI via PACS burning images to CD.
13.8 Logs the payment and reconciliation for all billable requests for PHI or Radiology Images.
13.9 Coordinates and processes requests for Affiliate Link users for CTRU, other internal auditors, and external providers (security procurement, tracking of users, and logging of the patients for viewing).
13.10 Update progress of requests assuring timely turn-around for all providers
13.10.1 Monitoring of Status Check Email through group mail account
13.10.2 Stat Transcribed reports as necessary for processing of releases.
13.11 Coordinates and processes MyChart Activation requests
13.12 Validation and Managetment of all pathology slides requests
13.13 Coordinates Subpoenas, Court Orders, and Search Warrants with WVUH Legal Services.
13.8 Must interpret medical terminology on releases to assure that records are released in accordance with HIPAA guidelines and State/Federal
13.9 Retrieve & deliver outgoing mail from mailroom on daily basis and sort appropriately.
13.10 Must have exceptional customer relations skills, listening skills, and problem-solving skills to appropriately process requests timely and accurately.
Other Skills and Abilities:
Ability to sit for long periods of time.
Endure excessive standing, bending, and stooping.
Have finger dexterity and complete use of hands, arms, and feet.
Knowledge of information system and numerical filing systems.
Good verbal/written and interpersonal skills; basic mathematical skills.
Prior experience with Microsoft window and storage systems.
Good organizational and problem-solving skills.
Be able to withstand stress of fast-paced environment.
Easily adjusts to change in policies, procedures, schedule, and fluctuation in workload.
Performance Standard: Adheres to the established Performance Expectations for WVUH Employees in the areas of People, Service, Performance Improvement, Shared Values & Culture.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Ability to lift, push or pull 11-20 pounds
Ability to sit for sustained periods of time
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Moderate level of adversity in working conditions – 21-50% of work time.
Standard Office Environment.
HIM Technician II Summary:
Education and Experience:
Graduate from an accredited program in Health Information Technology (HIT), preferred
Eligible to take the Registered Health Information Technicians Examination (RHIT)
Applicants in second year of HIT program may be considered
Department HEALTH INFO. MANG. ^546
WVUH Shift Day
WVUH Full-time/Part-time Full-time (40 hours)
Internal Transfer Only None Specified
About the Organization Looking for a challenge? If you are motivated, talented, and eager, there's a future for you at WVU Hospitals. We are looking for people with the desire to make a difference in healthcare.
WVU Hospitals, a 531-bed tertiary care center, teaching institution, that includes:
Ruby Memorial Hospital
WVU Children's Hospital
Chestnut Ridge Center (behavioral medicine)
Jon Michael Moore Trauma Center
Physician Office Center
Mary Babb Randolph Cancer Center
Betty Puskar Breast Care Center
WVU Heart Institute
Clark K. Sleeth Family Medicine Center
Rosenbaum Family House
Cheat Lake Physicians
Center for Reproductive Medicine
Pain Management Center
Wound Management Center
Sports Medicine Center
Sleep Evaluation Center
WVUH-Eastern Division (in the eastern part of the state)
Our employees are our most valuable asset. We offer competitive pay and benefits because we want to attract and retain employees who will support our mission of high quality patient care.
WVUH Hours per Week 40
Notes to Applicant None Specified
WVUH Start/End Time 8:15/4:45