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- Concurrent and post discharge/visit reviews of medical records for completeness in accordance with medical staff bylaws, rules and regulations, accreditation agencies, state and federal requirements.
- Assigns record deficiencies in the EHR to the appropriate clinician for timely completion.
- Provides support to clinicians with record completion activities, and appropriately responds to provider messages.
- Sends notifications regarding incomplete, delinquent and impending suspensions to individual clinicians as needed.
- Monitors compliance with hospital's bylaws, JCAHO, federal and state requirements for the timely and accurate completion of documentation. Distributes individual and aggregate reports regarding completion/timeliness performance to department chairs and executive leaders.
- Monitors and processes incoming dictations, communicates issues to vendor or clinician as appropriate. Ensures carbon copies are sent to referring physicians.
- Maintains Outside (Referring Physician) Provider Table and supports external continuity of care systems.
- Handles all release of information requests from patients (walk-in, calls, portal), attorneys, insurance companies, continuity of care, court orders/subpoenas, etc.
- Services patients and other HIMS customers through the HIMS call center, meeting service level agreement.
- Processes patient disability requests.
- Performs all scanning, indexing and review of documents, adhering to policy, standard operating procedures and service level agreements with clinical departments.
- Performs point of care scanning generated during an inpatient stay to deliver a more timely and complete electronic record.
- Performs quality reviews both prior to releasing to electronic health record and/or retrospective reviews to ensure accuracy and legibility of indexed documents.
- Performs patient identity verification for possible duplicate medical record numbers
- Performs chart corrections upon in-box notification from end-users
- Processes advanced directives, renders as valid or invalid upon validation process.
- Performs audits on advanced directives ensuring timeliness, accuracy and quality.
- Processes outside patient expirations and enters opt out information into the patient registration system.
- Retrieves requested physical medical records from onsite and/or offsite storage facilities.
- Performs account review to identify charge errors and or charge movement as necessary.
- Captures charges for clinic infusions, drug administration and extended recovery accounts.
- Combines patient accounts as required to enable coding and billing for services provided on same day.
- Audits a sampling of clinic accounts for charge capture accuracy.
- Compiles review data and reports trends to supervisor for follow up and education as necessary.
- Supports the coding team with documentation and charge correction follow up.
- Completes special projects as assigned.
- Departmental/Other:
- Assists with testing of HIMS systems during implementations and upgrades as needed.
- All other duties as assigned
- Post High School or equivalent.
- Three years medical record experience required. Solid knowledge of regulatory requirements governing medical record processing, charge capture, and release of information.
- Must have experience in infusion hospital billing
- Must have hospital billing experience as opposed to professional billing
- Knowledge of Title 22, CMS, Joint Commission Standards, State and Federal regulations, including HIPAA relating to record processing requirements and release of information
Health Information Specialist III - San Francisco, United States - KORE1 Technologies
Description
Details:
KORE1, a nationwide provider of staffing and recruiting solutions, has an immediate opening for a remote Health Information Specialist III.
Essential Functions:
Details:
Specializing in creative and technical recruiting, KORE1 is committed to supporting top IT and Creative professionals in their career paths. We build deep relationships with leading companies, connecting them to exceptional talent every day. With extensive industry expertise and unmatched opportunities, our goal is to provide a unique experience for our contractors and consultants as they prepare for their next role. We are passionate about matching the right people with the right companies.
Kore1 provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Kore1 complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Kore1 expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status.Improper interference with the ability of Kore1's employees to perform their job duties may result in discipline up to and including discharge.