Health Information Management Manager

Lifescan Labs of Illinois - Position Summary: The Manager, Health Information Management is responsible for the integrity and quality of medical records including the master patient index, release of information, and documentation audits. The Manager ensures that processes and procedures are designed to meet state and federal requirements for quality and completeness of documentation, release of information, and records retention. The Manager strives to optimize performance through technology, process automation, and standard operating procedure implementation. Partnering with the Sales and Operations Teams evaluates and optimizes processes to improve the client experience, enhance operational efficiencies, and drive revenue growth. Essential Job Functions: Provides oversight of the master patient index to ensure duplicate patient accounts are identified and resolved. Monitors system reports to identify patients with duplicate accounts and analyzes each account to identify the host and merging accounts. Develops, implements, and revises standard operating procedures for departments creating new patient accounts. Provides cross-departmental training as needed to reduce duplicate patient accounts. Collaborates with IT Analysts to develop and execute duplicate patient account resolution project plans. Monitors project through completion and resolution of duplicate accounts. Processes all subpoena requests by releasing requested patient records in accordance with the subpoena, HIPPA regulations, and LifeScan Labs policy and procedures. Manages insurance payer requests for medical records and releases requested patient records in accordance with the payer guidelines, HIPPA regulations, and LifeScan Labs policy and procedures. Coordinates with Account Managers to obtain letters of medical necessity or potential exposures from Client Medical Directors to assist the accounts receivable team with processing appeals. Reviews Medicare medical necessity national coverage determinations and develops in-servicesfor clients and LifeScan Lab personnel to decrease lack of medical necessity diagnosis code edits. Assists the Client Services Team with ICD diagnosis and CPT test related questions and Client Portal Claims pending due to lack of medically necessary diagnoses. Performs audits on accessions and orders and reports findings to the Compliance Director. Develops training action plans for Clients to improve order documentation. Schedules weekly business review meetings with the offshore team to assess performance and key performance metrics when assisting with subpoena research or resolving duplicate patient accounts. Works with Chief Revenue Cycle Officer on staffing level, developing productivity and quality metrics for offshore Agents. Executes and monitors productivity and quality performance per Agent. Assists IT with testing new features and functions in the practice management system. Develops training material and trains staff members on new revenue cycle system implementations in collaboration with It Project Managers. Monitors Medicare and payer policy routinely to identify changes affecting process flow, medical necessity, and reimbursement. Acts as point of contact for coding edit implementations across technology platforms. Works with IT to ensure a smooth upload of quarterly coding edit updates. Creates tools needed to communicate changes. Collaborates with Directors, to disseminate new regulatory and payer changes to the Revenue Cycle, Sales, and Operations Teams. Remains current with trends, regulatory requirements, and business strategies related to the payer relations and revenue cycle. Operates in compliance with all local, state, and Federal laws as well as policy and compliance standards. Other duties and responsibilities as assigned. Education and Experience: Bachelor’s degree in a health information management, healthcare, or a related field required. 3 - 4 years-experience in health information management. RHIA or RHIT credential preferred. Supervisory Responsibilities:Manages offshore team members. Key Job Competencies: Microsoft Office skills – Proficiency with Excel, Power Point, Word, and Visio. Exceptional detail orientation, critical thinking, analytical, and problem-solving skills. Ability to work autonomously and efficiently within designated timeframes in a fast-paced environment. HIPPA compliance and release of information requirements. Ability to interpret and apply government and insurance payer guidelines. Expert in medical necessity and ICD coding systems. Ability to collaborate and work cohesively as part of a team. Communicates effectively orally and in writing with all levels of the organization and an offshore team. Customer service client first aptitude. Schedule: Monday - Friday from 9:00am - 5:30pm