Health Information Management Specialist Level I

NYC Health + Hospitals provided pay range

This range is provided by NYC Health + Hospitals. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$/yr - $/yr

Kings County Hospital Center has a rich legacy for its pioneering role in medicine. Today, with over 625 beds, our hospital remains on the cutting edge of technology and provides the most modern procedures with state-of-the-art equipment. Built in 1831 as a one room infirmary for publicly supported care of the sick, Kings County Hospital Center continues to be a leading healthcare facility whose mission is to provide care to everyone regardless of their ability to pay.

The hospital provides a wide range of health services, and specialties are offered in all fields of modern medicine. More than 200 clinics provide a wide array of ambulatory care services. At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Purpose of Position
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This class of positions encompasses supervisory and/or administrative work of varying degrees of difficulty and responsibility in the field of health information management. Performs quality review of records and/or documentation provided by clinical staff. Contributes to, and ensures the appropriateness of code and Diagnosis-Related Group (DRG) assignment in order to facilitate consistency, accuracy, and efficiency in claims processing, data collection, and quality reporting.

All personnel perform related work.

Under supervision, performs assigned duties related to medical record and health information documentation, coding, validation, processing, and quality assurance.

• Validates the completeness, accuracy, and specificity of code assignments for inpatient, outpatient, and ambulatory surgery records in accordance with established coding guidelines. Ensures that all documented diagnoses and procedures are properly coded.
• Validates the accuracy of DRG assignment.
• Validates the accuracy of additional information abstracted from the clinical record.
• Monitors denials and appeals. Performs DRG denial reviews for appropriate parties. Ensures that denials are responded to in a timely manner; submits monthly reports.
• Monitors data integrity and accuracy; makes necessary data corrections and entry. Performs chart review to determine data quality.
• Identifies and reports on cases with documentation inadequacies, inconsistencies, and other issues with opportunities for improvement. Evaluates root causes and proposes corrective action for same.
• Generates physician queries as needed in order to obtain clarification of medical record documentation. Validates that physicians have been queried according to established procedure.
• Confers with coding specialists, and oversees and evaluates work performance. Provides ongoing and specific feedback to coding staff and management team regarding review findings.
• Provides education and training to new and existing health information management staff.
• Instructs physicians, nurses, health information management staff, and other appropriate personnel regarding documentation requirements as related to coding.
• Works with other departments to ensure that accurate reporting and reimbursement are facilitated.
• Assigns codes for diagnoses and procedures according to the current classification system for inpatient, outpatient, and ambulatory surgery records and in accordance with established coding guidelines.
• Performs concurrent and retrospective clinical documentation review and provides data when necessary.
• Reviews and analyzes clinical records for compliance with appropriate regulatory requirements.
• Effectively utilizes computer applications and other coding and abstracting software and hardware as necessary.
• Performs other related duties as assigned or directed.

• Possession of a Registered Health…