HIM SPECIALIST - DUHS-HIM Release of Information
PRMO:, established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke PrimaryCare. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke’s reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a HIM Specialist who will embrace our mission of Advancing Health Together.
Independently performs specialized or advanced health information activities necessary to organize, maintain, and use electronic patient health records.
Activities required include research, analysis and compilation of findings into summarized reports that will be shared within and external to the Health Information Management
Department.Positions at this level have high customer service, strong analytic and problem solving skills, require interpretation and explanation of policy and external requirements related to, privacy, release of information, positive patient identity, and other department and organization-wide functions.
Specific job responsibilities are based on the service unit within Health Information Management assigned.
Expert computer skills to navigate and query multiple electronic record systems.
Release of Information: regular interaction required with patients, attorneys, and governmental agencies, providers of health care, insurance companies, auditing agencies, and researchers.
Detailed working knowledge and ability to apply HIPAA rules, North Carolina General Statutes, and other State and Federal laws regarding patient privacy.
Patient Identity Management: regular interactions required with patients, attorneys, insurance companies, providers of healthcare and governmental agencies.
Detailed working knowledge and ability to apply State and Federal laws regarding positive patient identification, identity theft, vital records regulations, Joint Commission requirements, and CMS guidelines and rules.
Duties and Responsibilities of this Level
Release of Information Functions:
Review request for medical records to identify dates of service, entity, provider and specific clinical documents requested.
Works extensively in the electronic health record and de-centralized electronic databases to locate specific clinical documents for the purpose of fulfilling a request.
Reviews patient authorizations to validate HIPAA required elements and validate legal authority of requestor. Reviews NC and Out of State Subpoenas and Court Orders to determine if valid and returns to requestor if deemed invalid.
Co-ordinates visits from Health Plan Reviewers and Research Monitors through provision of electronic medical records, assignment of passwords and deactivates passwords at conclusion of visit.
Assists reviewer in locating specific documents as needed.
Reviews requests for patient amendments, locates disputed documents in the electronic health record and notifies provider of patient request for amendment.
Tracks amendment request to ensure patient is notified of outcome within HIPAA required time frame.
Obtains Itemized Statements from PRMO Self Pay and uses to calculate lien balances and generate Attorney Lien letter and forwards Itemized Statement to requestor as needed.
Obtains provider approval to release psychiatric encounter records when requested by patient and seeks provider approval to release records for minor patients ages 12-17 to parent to comply with additional privacy protections under NC Statute and Federal Law.
Accompanies certified copies or original health records to court and location of scheduled depositions when required.
Testifies in court and depositions as to the authenticity of health records containing PHI.
Perform other duties as assigned.
Required Qualifications at this Level
Associate’s degree in a health information management required
2 years’ experience in Health Information Management required
Bachelor's Degree in HIT Preferred
Degrees, Licensure, and/or Certification:
RHIT or eligible to sit.
RHIT must be obtained within 6 months of hire.
Knowledge, Skills, and Abilities:
Good organizational skills, excellent investigative/analytic skills with detail orientation, and strong follow-through capabilities.
Excellent verbal and written communication skills in order to effectively problem solve, develop working relationships and assist system users.
Must be able to meet deadlines, work independently, set priorities and maintain confidentiality.
Ability to work calmly and efficiently in high-pressure situations.
Intermediate knowledge of human anatomy and physiology and medical terminology highly preferred.
Intermediate to Expert skills using Windows-based software, familiarity with information technology hardware and software in a local and wide area network environment.
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.