HIM TEAM LEAD – Deficiency Management | Duke University Health System

Duke University Health System

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 PrimaryCare.

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 Performs specialized health information activities necessary to organize, maintain, and use electronic patient health records.

Positions at this level have high customer service, strong analytic and problem solving skills, require interpretation and explanation of policy and internal requirements related to health record documentation and completion, Medical Staff Bylaws, Rules and Regulations and organization-wide functions and policies and procedures.

Specific job responsibilities require skill set based on the service unit within Health Information Management.

The staff member performs HIPAA compliant screening of incoming requests for protected health information of our patients, distribution of medical records, deficiency management to assure compliance with federal and state regulatory and accrediting body requirements for health record content and timely completion and document management to include the capture of health records in an electronic format.

Excellent computer skills are required to complete basic to intermediate tasks within Maestro Care, Solarity, Hyland OnBase and other related applications.

Duties and Responsibilities of this Level Deficiency Management Functions: Analyzes electronic medical records to ensure compliance with regulatory requirements, Medical Staff Bylaws, and hospital policy.

Identifies and assigns the deficiency to the appropriate provider to complete the missing documentation (15%) Monitors the status of incomplete medical records, generates physician reminder notices, prepares and submits a list of delinquent providers to Medical Staff and Administrative Leaders (10%) Monitors work queues and performs problem resolution where needed.

Liaison for staff as initial point of escalation with providers (10%) Provide education sessions to providers to complete deficiencies and clarify and/or explain the regulatory compliance and chart completion process within Maestro Care.

(10%) Run monthly reports for HIMOC and BSC and maintain the Deficiency department/division database.

(10%) Supports leadership by initiating and reviewing weekly provider suspension list.

(5%) Assists in creating training and job aides to support Deficiency Management staff related to the specific job areas and Maestro Care upgrades.

Collaborate with the unit supervisor to provide initial and ongoing training with unit support staff to ensure consistent and standardized operating procedures.

(20%) Monitor and QA staff for quality/productivity.

(20%) Required Qualifications at this Level Education: High school or GED diploma required, Advanced knowledge in entity Bylaws related to Joint Commission accreditation and CMS regulations.

Experience: 2 years of experience in Health Information Management, Document Management, or Healthcare Related Field required Associates / Bachelor’s Degree in Healthcare, Business, IT, or Related Field can substitute for 2 years’ experience Associates Degree in HIT preferred 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 in order 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 multi-task and work with a high degree of accuracy and recall.

Ability to train and interact with physicians.

Ability to work calmly and efficiently in high-pressure situations.

Intermediate knowledge of human anatomy and physiology and medical terminology highly recommended.

Intermediate skills using Windows-based software, familiarity with information technology hardware and software in a local and wide area network environment.

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.

Patient Revenue Management (PRMO)


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