HIM Operations Specialist II

Responsibilities

• Analyze and identify documentation needs based on services provided and coding queries, accurately classifying clinical documentation for all tests, treatments, procedures, and other services.
• Assign, edit, and track medical record deficiencies by responsible provider into the chart management system to support continuity of patient care, coding, and revenue cycle.
• Review, upload, and process Health Maintenance results and Advance Care Planning Directives into Epic based on state guidelines.
• Review clinical documentation for evidence of Diabetic Retinopathy, abstracting components to support Health Maintenance initiatives.
• Perform HIM and coding support functions, contributing to established metrics, key performance indicators, and turn-around-times.
• Obtain and import documentation from internal and external sources to justify and support accurate coding and billing for services performed by employed clinicians.
• Ensure compliance with organizational policies, Medical Staff Bylaws, and State and Federal regulations (e.g., TJC, DNV, CMS).
• Identify and escalate front-end or system workflow issues, collaborating with department leaders, clinical informatics, IT, coding, and HIM Optimization to resolve them.
• Validate deficiencies and chart completion status in the EHR to support reporting of incomplete and delinquent medical record documentation.
• Notify clinicians regarding incomplete documentation and inform leadership regarding accountability sanctions.
• Verify the validity of presurgical H&Ps and other documents received via OnBase work queue and upload them to the EHR.
• Incorporate internal and external clinical documentation from various sources into the EHR, routing to clinicians as appropriate while meeting quality, accuracy, and productivity benchmarks.
• Coordinate support activities, provide training, and educate Epic Connect clinics for transition to EPIC.

Qualifications

• High School Diploma or GED Equivalent.
• Typically requires 1 to 2 years of experience in healthcare.

Skills

• Ability to work independently and make decisions with minimal supervision, maintaining quality and productivity standards.
• Effective problem identification, problem-solving, and priority-setting skills.
• Proficiency in computer and keyboarding skills, with the ability to learn new software systems (e.g., Epic, OnBase, Solarity, Microsoft Office) and electronic communication platforms (e.g., Teams).
• High attention to detail and accuracy, with the ability to limit interruptions.
• Ability to prioritize workload and work under pressure in a fast-paced environment.
• Collaborative teamwork skills with openness and respect for learning, creating, and problem-solving.
• Adaptability to a fast-paced environment and task switching while maintaining quality and accuracy.
• Receptiveness to constructive feedback and personal ownership for success.
• Strong interpersonal, written, and verbal communication skills.
• Ability to safeguard protected health information (PHI) and basic knowledge of HIPAA.

Physical Requirements and Working Conditions

Operates all equipment necessary to perform the job in a normal office environment. Sits most of the workday and performs repetitive functions and hand movements.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.