HIM Specialist

Durham, North Carolina, PRMO Established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke Primary Care. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke’s reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance. General Description of the Job Class Independently performs specialized or advanced health information activities necessary to organize, maintain, and use electronic patient health records. Activities required include research, analysis, and compilation of findings into summarized reports that will be shared within and external to the Health Information Management Department. Positions at this level have high customer service, strong analytic and problem-solving skills, and require interpretation and explanation of policy and external requirements related to, privacy, release of information, positive patient identity, and other department and organization-wide functions. Specific job responsibilities are based on the service unit within Health Information Management assigned. Expert computer skills to navigate and query multiple electronic record systems. Release of Information: regular interaction is required with patients, attorneys, governmental agencies, providers of health care, insurance companies, auditing agencies, and researchers.

Detailed working knowledge and ability to apply HIPAA rules, North Carolina General Statutes, and other State and Federal laws regarding patient privacy. Duties and Responsibilities of this Level Release of Information Functions: Review requests for medical records to identify dates of service, entity, provider, and specific clinical documents requested. Works extensively in the electronic health record and de-centralized electronic databases to locate specific clinical documents to fulfill a request. Reviews patient authorizations to validate HIPAA-required elements and validate the legal authority of the requestor. Reviews NC and Out of State Subpoenas and Court Orders to determine if valid and returns to the requestor if deemed invalid. Coordinates visit from Health Plan Reviewers and Research Monitors through the provision of electronic medical records, assignment of passwords, and deactivating passwords after the visit. Assists reviewer in locating specific documents as needed. Reviews requests for patient amendments locates disputed documents in the electronic health record and notifies the provider of patient requests for amendment. Tracks amendment requests to ensure the patient is notified of the outcome within HIPAA required timeframe. Obtains Itemized Statements from PRMO Self Pay and uses them to calculate lien balances and generate Attorney Lien letters and forwards Itemized Statements to the requestor as needed.

Obtains provider approval to release psychiatric encounter records when requested by the patient and seeks provider approval to release records for minor patients ages 12-17 to parents to comply with additional privacy protections under NC Statute and Federal Law. Accompanies certified copies of original health records to court and location of scheduled depositions when required. Testifies in court and depositions as to the authenticity of health records containing PHI. Required Qualifications at this Level Education High School Diploma required Associate’s degree in a Health Information Management or related field preferred Experience Four years of experience in Health Care related fields are required, two of which must be in Health Information Management Or Candidates with an Associate’s degree in HIM require two years of Health Care experience and one year of HIM-specific experience or Candidates with a Bachelor’s degree in HIM require two years of Health Care experience or Candidates with a Bachelor’s degree in Health Care require two years of HIM-specific experience Degrees, Licensure, and/or Certification Preferred: RHIT/RHIA/CHPS/CHDA   Knowledge, Skills, and Abilities Good organizational skills, excellent investigative/analytic skills with detail orientation, and strong follow-through capabilities. Excellent verbal and written communication skills to effectively problem solve, develop working relationships and assist system users. Must be able to meet deadlines, work independently, set priorities, and maintain confidentiality. Ability to work calmly and efficiently in high-pressure situations. Intermediate knowledge of human anatomy and physiology and medical terminology is highly preferred. Intermediate to Expert skills using Windows-based software, familiarity with information technology hardware and software in a local and wide area network environment. Distinguishing Characteristics of this Level N/A This job description intends to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position.

Employees may be directed to perform job-related tasks other than those specifically presented in this description. Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.     Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.   Duke aspires to create a community built on collaboration, innovation, creativity, and belonging.

Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.   Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.  

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