Manager, Health Information

Do you want to work for one of Rochester’s premier health organizations? Do you have supervisory, compliance & coding expertise? This growing company provides a sense of community, connection, and support.  This is a chance to be an integral part of a well-established, respected organization!

• Ability to review and evaluate medical records for the appropriateness and medical necessity of services and procedures billed based on supporting documentation.
• Knowledgeable regarding ICD10 and CPT codes, billing guidelines, payer policies, and related industry standards.
• Develop audit work plans and perform audit functions in all billable programs including Medicaid and Medicare.
• Prepare written and oral communication to the Compliance Committee members and appropriate individuals regarding audit results.
• Provide professional documentation/coding training and advice as appropriate.
• Develop policies and procedures pertaining to all audits/coding checks that are routinely performed.
• Assist with follow-up responses for external audits/site visit findings and plans of correction identified by funders/payers.
• Provide back-up for Compliance Audit & Risk Manager for other compliance audits as needed.
• Responsible for supervision of the Health Information Management Technicians. Primary duties are to provide active support for all activities, training and organization associated with appropriate management of patient medical records abiding by the requirements of the NYS Department of Health’s regulations.
• Work with HIM staff to ensure that Health Information Management policies and procedures meet the requirements of New York State and Federal Laws and Regulations.
• Formulate procedures for the systemic storage and retrieval of medical records, and the destruction of outdated records from the company’s document retention vendor.
• Oversee the process of information releases for outside entities such as insurance companies, federal and state agencies, business associates, external referral sources, and patient requests.
• Provides day to day supervision and assignment management to direct reports.
• Develops and maintains collaborative working relationships with staff at all levels within the organization.
• Provides positive leadership, expectation setting, project oversight and support, coaching, and regular performance feedback to direct reports.
• Hires staff and manages job descriptions, job requirements, expectations, time sheets and PTO, etc. for direct reports.
• Maintains departmental climate that attracts, retains, and motivates high performing talent.
• Develops and manages appropriate policies and procedures related to all areas of responsibility.
• Collaborate to ensure compliance of all laws and regulations.
• Responsible for auditing program compliance.
• Assist the Risk and Compliance Audit Manager with additional audits when requested by Risk and Compliance Audit Manager or Director, Compliance, Privacy & Risk.
• Assist Risk Manager with maintaining an updated risk assessment program.
• Responsible for annual HIPAA Risk Assessment under the direction of the Privacy Officer.
• Assists in the development of policies and procedures regarding HIPAA privacy practices.
• Assist Director of Compliance in the development of HIPAA training.
• Reports activities at the Quarterly Compliance Committee meetings. Provides Support to Director, Compliance, Privacy & Rick for the quarterly organizational Compliance Meeting agendas, documenting, and distributing meeting minutes, scheduling conference rooms and sending meeting requests to committee members.
• Shares responsibility for monitoring the Compliance Hotline to ensure that any issue reported to the hotline is investigated, documented and resolved.
• Research projects, obtain compliance/regulatory information for new agency services upon request.

Bachelor’s degree preferred with concentration in Nursing, Health Information Management, Business Administration or a related field, and seven years of combined experience in clinical, claims processing, compliance and/or internal audit environment required.

Minimum requirement of High School diploma and twelve years of direct auditing and coding, health information management oversite and compliance experience.  Five years of supervisory experience as well as reimbursement principles, claims processing and healthcare compliance concepts required. Maintain certification as a Certified Coding Specialist (CCS) as well as being connected to either AAPC or AHIMA for coding updates.