Health Information Management Specialist- Level I

New York, NY, United States

Elmhurst Hospital Center (EHC) is the major tertiary care provider in the borough of Queens. The hospital is comprised of 545 beds and is a Level I Trauma Center, an Emergency Heart Care Station and a 911 Receiving Hospital. It is the premiere health care organization for key areas such as Surgery, Cardiology, Women's Health, Pediatrics, Rehabilitation Medicine, Renal and Mental Health Services.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Work Shifts

8:00 A.M - 4:00 P.M

Job Description

This class of positions encompasses supervisory and/or administrative work of varying degrees of difficulty and responsibility in the field of health information management. Performs quality review of records and/or documentation provided by clinical staff. Contributes to, and ensures the appropriateness of code and Diagnosis-Related Group (DRG) assignment in order to facilitate consistency, accuracy, and efficiency in claims processing, data collection, and quality reporting. There are two (2) Assignment Levels within this class of positions; all personnel perform related work.

Duties & Responsibilities

1. Validates the completeness, accuracy, and specificity of code assignments for inpatient, outpatient, and ambulatory surgery records in accordance with established coding guidelines. Ensuresthat all documented diagnoses and procedures are properly coded.

2. Validates the accuracy of DRG assignment.

3. Validates the accuracy of additional information abstracted from the clinical record.

4. Monitors denials and appeals. Performs DRG denial reviews for appropriate parties. Ensures that denials are responded to in a timely manner; submits monthly reports.

5. Monitors data integrity and accuracy; makes necessary data corrections and entry. Performs chart review to determine data quality.

6. Identifies and reports on cases with documentation inadequacies, inconsistencies, and other issues with opportunities for improvement. Evaluates root causes and proposes corrective actionfor same.

7. Generates physician queries as needed in order to obtain clarification of medical record documentation. Validates that physicians have been queried according to established procedure.

8. Confers with coding specialists, and oversees and evaluates work performance. Provides ongoing and specific feedback to coding staff and management team regarding review findings.

9. Provides education and training to new and existing health information management staff.

10. Instructs physicians, nurses, health information management staff, and other appropriate personnel regarding documentation requirements as related to coding.

11. Works with other departments to ensure that accurate reporting and reimbursement are facilitated.

12. Assigns codes for diagnoses and procedures according to the current classification system for inpatient, outpatient, and ambulatory surgery records and in accordance with establishedcoding guidelines.

13. Performs concurrent and retrospective clinical documentation review and provides data when necessary.

14. Reviews and analyzes clinical records for compliance with appropriate regulatory requirements.

15. Effectively utilizes computer applications and other coding and abstracting software and hardware as necessary.

16. Performs other related duties as assigned or directed.

Minimum Qualifications

1. Possession of a Registered Health Information Administrator (RHIA) credential from AHIMA and two (2) years of satisfactory experience in coding and abstracting medical records in a recognized hospital or health care organization, of which one (1) year has been in a supervisory and/or administrative capacity; or

2. Possession of a Registered Health Information Technician (RHIT) credential from AHIMA and four (4) years of satisfactory experience in coding and abstracting medical records in a recognized hospital or health care organization, of which two (2) years have been in a supervisory and/or administrative capacity; or

3. Possession of a valid certificate as a Certified Coding Specialist (CCS) from AHIMA and six (6) years of satisfactory experience in coding and abstracting medical records in a recognized hospital or health care organization, of which three (3) years have been in a supervisory and/or administrative capacity; or

4. A satisfactory equivalent of education and experience.

If you wish to apply for this position, please apply online at employment.nychhc.org.

NYC Health and Hospitals offers a competitive benefits package that includes:

Comprehensive Health Benefits for employees hired to work 20+ hrs. per week

Retirement Savings and Pension Plans

Loan Forgiveness Programs for eligible employees

Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts

College tuition discounts and professional development opportunities

Multiple employee discounts programs