Supervisory Medical Records Administration Specialist

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center.

Position Summary:

This position is located within the Tohono O'odham Nation Health Care (TONHC) Hospital and Clinics. The work involves developing new or improved solutions to complex technical problems; establishing criteria; formulating projects; assessing program effectiveness; investigating and analyzing unusual conditions, concerns, or questions for Health Information Management Services (HIMS).

Scope of Work: This is the senior Health Information Management Services position for TONHC Hospital and Clinics. Under the Director's general direction, the incumbent functions as the Health Information Management Services (HIMS) and has full program responsibility to set and carry out the strategic direction, mission, and vision for TONHC Hospital and Clinics Health Information Management Services.

• Interpret national health record policies and standards for application at the Hospital and Health Centers level. At local and national meetings, the incumbent represents Tohono O'odham Nation Health Care (TONHC) Hospital and Clinics.
• Formulates health record policies specific to the Tohono O'odham Nation Health Care (TONHC) Hospital and Clinics and directs their application; writes policy and procedures for medical records and coding for electronic health records and paper records as applicable.
• Evaluate Health Center level of compliance with the Joint Commission (TJC) applicable continuous quality improvement standards and monitors operation of Health Center record centers under HIPAA (Health Insurance Portability and Accountability Act), Privacy Act, and Freedom of Information Act.
• Directs the overall operations of the HIMS program and provides leadership and guidance to the other TONHC Hospital and Clinics facilities; and ensures TONHC Hospital and Clinics has an integrated, consistent, and comprehensive patient health records system.
• The incumbent develops, analyzes, and implements procedures for assuring proper inter-departmental and intra-departmental workflow.
• Continually evaluates and reviews procedure adequacy; and, if necessary, modifies to meet latest technical requirements and techniques; evaluates statistical data identifying program adequacy to management.
• Ensures departmental goals and objectives are consistent with the TONHC strategic plan and provides advice and assistance in health information requirements and medicolegal aspects to the Sells Hospital and Health Centers.
• Serve as an advisor to management on all phases of health information management. Serve as the CO-Chair (with Medical Staff) of the TONHC Hospital and Clinics Health Information Management Committee (HIMC), composed of medical and professional services members.
• Advise on the adequacy of health records and medicolegal aspects of health record operations at Health Centers. Responsible for medical statistical reports to assist hospital management and accrediting agencies in evaluating the quality of clinical care.
• Assist Compliance Officer to train and educate staff on the key requirements of Privacy Standards, including limits on use and disclosure of protected health information, individual rights under regulations, and administrative requirements.
• Accepts subpoena duces tecum, as custodian of the health record, reviews subpoenaed records for completeness with medicolegal requirements. Confers with TON attorney, when necessary, appears in court to fulfill legal requirements. Prepare records in tort claims.
• Utilizing Electronic Health Record template approval criteria ensures that EHR templates are acceptable for use.
• The incumbent is responsible for the administration and management of the TONHC Hospital and Clinics Medical Coding Program. Coordinates, manages, monitors, and performs all functions necessary to ensure coding complies with internal control standards.
• Incumbent utilizes and implements various auditing mechanisms to ensure coding compliance. Develops and implements a comprehensive internal quality control system within the HIMS program. Determine the effectiveness of such controls and their impact on the program.
• Responsible for the RPMS software packages managed by the HIMS discipline: Discharge and Transfer (ADT), Patient Care Component (PCC), Release of Infom1ation (ROI); Sensitive Patient Tracking (SPT), Text Integration Utility (TIU) of EHR, and other HIM package developed by TONHC.
• Responsible for the review, analysis, and technical evaluation of clinical records concerning the Standards of the Joint Commission (TJC) and state and federal reporting requirements for vital statistics.
• Assures that diagnoses are written in the language of Standard Terminology of Diseases and Operation, and coding of diseases and operations are in the proper grouping of International Classification of Diseases and Operations for research and administrative evaluation.
• Aids in projects by advising on procedures to efficiently collect data and assisting staff in defining their objectives in terms of the available information. Collection of data may consist of searching files or recommending special computer reports.
• Designs and administers the health information program, including managing work processes, personnel, and planning for transition to the EHR.
• Responsible for conducting and submitting (to CEO) specific assessments related to Third Party Internal Controls self-assessment and audits.
• The incumbent supervises a staff engaged in administrative and technical work. Ensure the timely performance of satisfactory quality and quantity of work through the following supervisory tasks.
• Plans work to be done by subordinates; sets priorities and establishes schedules and deadlines. Assign work based on anticipated difficulty and the capabilities of available employees. Advises, counsels, and instructs employees on technical and administrative matters.
• Ensures HR (competency) files are in place and up-to-date, meeting all TONHC Joint Commission requirements.
• Recommends personnel actions such as promotion, reassignment, or termination. Recommends awards and disciplinary actions.
• Submit requests for personnel action timely. Interviews applicants and recommends selections.
• Hears and resolves employee complaints (or refers the complaint to the level of resolve.
• Determines individual training and development needs and seeks out ways to satisfy them.
• The incumbent is responsible for furthering the goals of Equal Employment Opportunity (EEO) by taking positive steps to ensure adherence to non-discriminatory employee practices regarding race, color, sex, religion, national origin, age, or handicap.
• Contribute to a team effort.
• Performs other job-related duties as assigned.

Knowledge, Skills, and Abilities:

• Knowledge of the Tohono O'odham culture, customs, and traditions.
• Thorough knowledge of medical records administration and management to apply established principles, concepts, and techniques of hospital operations.
• Thorough knowledge of policies, procedures, applicable Federal statutes on legislation governing health records.
• Advanced knowledge and understanding of health information management: including coding, medical terminology, documentation standards, electronic health record (EHR), and medicolegal issues of the health record.
• Advanced analytic skills to be able to solve problems covering the diverse issues that are involved in the health records management field.
• Advanced knowledge of medical terminology, understanding the standard practices of the clinical medical field and communicating effectively with the clinical .staff in interpreting and comprehending medical documentation in health records. Practical knowledge of anatomy, physiology, and medical procedures and diagnosis.
• Ability to plan, organize and cope with complex management issues. Ability to handle technical problems analytically and systematically, especially in times of medical or administrative emergencies.
• Ability to communicate effectively, orally, and in writing to all levels of personnel. Effective communication is needed to coordinate with various department personnel, patients, agency personnel, and outside entities requesting or requiring information related to health records.
• Expert knowledge in developing procedures, planning, organizing, and monitoring studies involving data analysis and preparing reports.
• Thorough knowledge of Public Law 94-437, Title IV of the Indian Health Care Improvement Act, PL 99-272, Federal Medical Care Cost Recovery Act, the Drug Abuse Office and Treatment Act of 1972; hospital policies and procedures governing the recovery of the cost of medical care provided to specific individuals.
• Knowledge of reimbursable insurance procedures and requirements, including interpreting provisions of individual health plans and group plans.
• Knowledge of proper coding procedures, ICD-10 and CPT.
• Thorough knowledge of the Resource Patient Management System (RPMS).
• Expert knowledge of regulatory, licensing, accrediting agency requirements, and medical/legal responsibilities of medical records (including electronic health records).
• Expert knowledge of the interrelationships between medical records programs and other medical care services to evaluate and modify/adapt new procedures to meet changing regulatory requirements and health care practices.
• Knowledge of supervisory personnel management responsibilities, including recruitment and staffing, training, incentive awards, discipline, position classification, pay administration.

Minimum Qualifications:

• Associates in Medical Billing and Coding or closely related field, and
• Three years of supervisory experience in Health Information Management Services (HIMS).

Licenses, Certifications, Special Requirements:

• Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) is desirable.
• Upon recommendation for hire, a criminal background and a National FBI fingerprint check are required to determine suitability for employment, including a 39-month driving record.
• May require possessing and maintaining a valid driver's license (no DUIs or major traffic citations within the last three years).
• If required, must meet the Tohono O'odham Nation tribal employer's insurance requirements to receive a driver's permit to operate program vehicles.
• Based on the department's needs, incumbents may be required to demonstrate fluency in both the Tohono O'odham language and English as a condition of employment.