176320
HEALTH INFORMATION SPECIALIST
MS513 $43,784 - $78,790
Creation Date: 01/05/2024
Change Date: 01/01/2025
FUNCTION OF WORK:To review health records to ensure appropriate allocation of its resources for a facility's utilization review program.
LEVEL OF WORK:SUPERVISION RECEIVED:General direction from a Health Information Supervisor or other higher-level agency personnel.
SUPERVISION EXERCISED:May functionally supervise lower-level staff.
JOB DISTINCTIONS:Differs from Health Information Coordinator 3 by the presence of auditing health records for compliance with federal, state or utilization review purposes.
Differs from Health Information Supervisor by the absence of direct supervision.
CORE COMPETENCIES: CORE COMPETENCIES HAVE NOT BEEN IDENTIFIED BY STATE CIVIL SERVICE FOR THIS JOB TITLE.
MORE INFORMATION ON THE SCS COMPETENCY MODEL CAN BE FOUND
HERE.
EXAMPLES OF WORK:EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.
Performs admission, continued stay, and discharge reviews.
Performs quantitative analyses and audits of charts for utilization review planning.
May lead lower-level health information or clerical positions in the collection and interpretation of health records.
Applies medical terminology and facility guidelines to determine the principal diagnosis and applicable allocation of resources.
Makes corrections and adjustments to charts, files, and other health records in order to maintain compliance with federal, state, for facility regulations.
Analyzes health care data for the purpose of enhancing the hospital's services and to optimize reimbursement.
Conducts statistical analyses of health records and prepares reports for Utilization Review or other facility committee(s).
May develop and maintain the utilization review plan.
May schedule utilization review committee meetings.
May code diagnoses, procedures, and symptoms for data collection and processing.
Audits health data collection and processing activities (e.g., coding, indexing, and statistics).
Assists third party auditors for compliance with Medicaid, Medicare, or other federal or state regulations.
QUALIFICATION REQUIREMENTS:MINIMUM QUALIFICATIONS:
Three years of experience in medical records or as a patient coder; OR
Two years of experience in medical records or as a patient coder plus registration with the American Health Information Management Association, as a Registered Health Information Technician (RHIT), a Certified Coding Specialist (CCS), or a Registered Health Information Administrator (RHIA); OR
A bachelor's degree in health information.