Medical Records Coder

Horizon PACE is excited to announce an amazing opportunity to be part of Horizon PACE’s program (Program of All-Inclusive Care for the Elderly). This innovative program is for individuals 55 years or older, who are living with chronic illness, or disabilities and need coordinated medical care to continue living as independently as possible in their home and community. The healthcare team at Horizon PACE will approach coordinating medical, social, and home care services so individuals no longer need to manage their medical care alone. Horizon has over 25 years’ experience providing care in Kentucky and is the largest provider of adult day health care services in the state. Horizon is opening 3 PACE locations in Kentucky, and we are excited to expand services to older Kentuckians. Horizon has an excellent benefit package including competitive pay, medical, dental, vision, life coverages, as well as generous paid time off, holidays, 401K, and many more.

General Summary:

Under the supervision of the Quality Improvement/Compliance Officer, the Medical Records Coordinator is responsible for management and maintenance of all medical records, both in paper and electronic format, within HIPPA standards and regulatory compliance. This person assists quality improvement initiative and performs medical records audits.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required.

1. Must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact.

2. Must have a valid driver’s license, proof of insurance, and have a reliable means of transportation.

3. Education:

· Preferred to have experience working with maintenance of medical records.

4. Experience:

· Preferred to have 1year relevant experience.

· High level of organization skill.

5. Skill(s):

· Mental Skills: Reading-simple; reading-complex; writing-simple; writing-complex; clerical; memorization; repetition; organization; analyzing; perception/comprehension; math skills; judgment; decision-making; socialization; attention to detail and communication/poise.

· Interpersonal Skills:Demonstrates active listening techniques; gains support through effective relationships; treats others with dignity and respect; seeks feedback.

· Leadership Skills: Demonstrates willingness to try new tasks, generates new ideas for change, evaluates and recognizes priorities; challenges others to learn; keeps current and integrates new information; communicates and models organization values; fosters high performance.

ESSENTIAL FUNCTIONS

1. Maintains all medical records to ensure compliance with HIPPA standards and regulatory requirements.

2. Effectively navigates the electronic medical record.

3. Monitors paper records to ensure those records are properly maintained for scanning into the electronic medical record

4. Monitors medical records and audits for misfiles and appropriate assignment to the appropriate category. Educated staff accordingly.

5. Works with staff to “thin” medical records on a scheduled basis and as needed.

6. Audits scanned records to ensure that all required documents are scanned appropriately in the medical records.

7. Applies accurate coding is captured and entered in conjunction with the clinicians and the billing coder.

8. Enters and validates codes using the EMR to ensure accurate and timely submission and encounter reporting

9. Ensures timely, complete, and thorough document entry into the medical record to assist the quality and coding process.

10. Contacts external providers to ensure all required medical records or data regarding external testing, physician visits and hospital emergency room visits.

11. Coordinates requested for medical information for the enrollment process.

12. Obtains all documents from hospitals, providers, and other health entities as needed per physician request to ensure quality of care for the participants across the continuum. Prepared the initial record for enrollment process and prepared the record for review by team members.

13. Assists with internal medical record audits and provider audits and disseminates results to appropriate staff, leadership, or committees.

14. Provides staff support for regulatory reviews.

15. Abides by all confidentially requirements as they related to the release of PHI. Maintains all release of records forms and ensures that they are updated in a timely manner.

16. Processes all release of information requests from participants, significant others, facilities, and agencies. Maintains the request log and ensures compliance with all HIPPAA and privacy regulatory requirements. Documents all request on the EMR.

17. Provides staff support for specific committees and maintains filed, minutes, and follow through.

18. Supports and assists the finance/accounting department with claims processing activities.

19. Follows Horizon PACE Policies and Procedures and applicable OSHA safety guidelines.

20. Protects privacy and maintains confidentiality of all company procedures, results and information about employees, participants, and families.

21. Practices Universal precautions.

22. Maintains safe working environment. Follows Horizon PACE Safety Policies and Procedures.

23. Participates in and supports Quality Improvement initiatives

24. Participates in continuing education classes and any required staff and training meetings. Maintains professional affiliations and any required certifications.

GENERAL RESPONSIBILITIES

1. Supports the Mission, Values, and Vision of Horizon PACE and adheres to the Corporate Compliance Code of Conduct.

2. Is knowledgeable of participant rights and ensures an atmosphere which allows for the privacy, dignity, and well-being of all participants in a safe, secure environment.

3. Supports, cooperates with, and implements specific procedures and programs for:

a. Safety, including standard precautions and safe work practices, established fire/safety/disaster plans, risk management and security, report and/or correct unsafe working conditions, equipment repair and maintenance needs.

b. Confidentiality of all data, including participant, employee and operations data and reports breaches immediately to the HIPAA Privacy or Security Officer.

c. Quality Improvement and compliance with all regulatory requirements.

d. Compliance with current law and policy to provide a work environment free from harassment and all illegal and discriminatory behavior.

4. Supports and participates in common teamwork:

a. Cooperates and works together with all co-workers; plans and completes job duties with minimal supervisory direction, including appropriate judgment.

b. Uses tactful, appropriate communications in various situations.

c. Follows up as appropriate with supervisor, co-workers or participants regarding reported complaints, problems, or concerns.

d. Promotes positive public relations with participants, caregivers, and guests.

e. Adheres to attendance policies, including clocking in and out for mealtime, following break schedule, and seeking supervisor’s approval prior to working overtime.

f. Completes requirements for in-service training, uniform and dress codes including personal hygiene, and other work duties as assigned.

5. Assist supervisor with various tasks to support department operations as directed; may also be assigned special projects.

6. Perform tasks which are supportive in nature to essential functions of the job, but which may be altered or re-designed depending on individual circumstances.

7. Assists participants and caregivers in filing grievances.

Work Environment

The work environment characteristics described here are representative of those an employee may encounter while performing the essential functions of this job.

1. Visual, Hearing and Communication Requirements - Requires corrected vision and hearing to normal range. Must be able to communicate verbally with all staff, caregivers, participants, and community at large.

2. Pressure Factor - Requires working under stressful conditions. Working conditions may be noisy and crowded with fluctuating indoor temperatures. Moderate pressure to meet scheduled appointments. Subject to people that may have the potential for verbal or physical aggression.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

1. Physical Requirements – Shall be in good mental and physical health, and capable of performing assigned tasks. Employee positions require strenuous activity including pushing, pulling, lifting of 40 pounds or more, standing for long periods, extensive walking, and movement at different position levels. Employment is contingent on the ability to perform these duties with no limits or restrictions according to regular work schedule.

While this is intended to be an accurate reflection of the current job, this is not necessarily an exhaustive list of working conditions associated with the job. Management reserves the right to revise the job or to require that other or different tasks be performed when circumstances change (i.e., changes in personnel, workload, or technological development.

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Job Type: Full-time

Pay: $17.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Experience:

• ICD-10: 1 year (Preferred)

Work Location: In person

Salary : $17