Job Description

Position Title: Health Information Management Specialist Department : Health Information Management (HIM) Reports To: Health Information Management Team Lead FLSA: Non-Exempt Position Summary: The Health Information Management (HIM) Specialist is responsible for managing and safeguarding patient medical records and facilitating effective communication between patients and the medical records department. This role includes obtaining and managing Electronic Medical Record (EMR) access, liaising with patients and various medical records departments, and ensuring compliance with privacy regulations and organizational policies. The Specialist will support accurate and timely processing of medical records requests, contributing to high-quality patient care and efficient operations. Essential Duties & Responsibilities:
EMR Access & Management:
Obtain and manage EMR access for various facilities, ensuring seamless integration and up-to-date patient information.
Patient Liaison:
Serve as the point of contact for patients regarding medical record inquiries, ensuring clear communication and resolution of issues.
Record Evaluation:
Review and verify patient medical records to ensure accuracy, completeness, and compliance with regulatory requirements.
Request Processing:
Manage the flow, evaluation, research, and processing of medical record requests promptly according to payer-specific guidelines.
Compliance Monitoring:
Conduct thorough investigations of all medical records for unprofessional language before submission and notify the Compliance team of any discrepancies.
Trend Analysis:
Identify and report payer trends with carriers to the designated associate.
Documentation & Reporting:
Prepare appropriate written documentation, maintain necessary files, and document follow-up notes on accounts.
Scan and upload all documents into the Electronic Health Record (EHR) system.
Follow-Up:
Follow up on medical records submissions with no insurance response and maintain any daily spreadsheets required by the supervisor.
Audit & Review:
Notify leadership of, and respond to, additional documentation requests (ADR), audits, and post-payment reviews as required.
Accountability:
Maintain accountability and identify trends through detailed documentation and reporting.
Support Functions:
Perform additional duties as assigned by the Medical Records Manager.

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