Health Information Manager

Key Responsibilities

• Ensure the availability and integrity of medical records in accordance with hospital policy
• Manage operational aspects of the Health Information Management Department
• Serve as a resource to staff regarding medical record content, compliance, and regulatory standards
• Oversee Physician/LIP credentialing and recredentialing in compliance with company policies and procedures
• Ensure all duties are performed in accordance with facility policies, JCAHO standards, federal and state regulations, and QAPI standards
• Utilization Review (UR) Role:
• Assist with coordination of insurance benefits for all patients across the organization
• Ensure preauthorization for covered days is obtained for all required third-party payers
• Communicate effectively with insurance companies, practitioners, therapists, nurses, and other staff to ensure utilization data is appropriately documented in medical records
• Maintain patient privacy by following hospital policy and federal privacy laws
• Maintain electronic insurance files for each patient admitted to the hospital
• Cookordination with the corporate office regarding utilization review activities
• Perform other duties as assigned to support department and facility operations

Education & Skills

• Experience in Health Information Management or related field preferred
• Prior experience in Health Information Management and Utilization Review in a hospital or healthcare setting
• Knowledge of medical record standards, regulatory requirements, and credentialing processes
• Strong organizational and communication skills
• Proficiency with electronic health records systems and insurance documentation
• Ability to maintain strict confidentiality and compliance with HIPAA regulations