HIM QA Analyst

UofL Health - Louisville, KY

Full-time - Mid Level

Louisville, KY

10,001+ employees

Hospitals

About the position

UofL Health is seeking a HIM QA Analyst to join our team in Louisville, KY. This position plays a crucial role in auditing and analyzing the Legal Health Record (LHR) to ensure compliance with the Centers for Medicare and Medicaid Services (CMS) and Joint Commission Record of Care documentation standards. The HIM QA Analyst will perform administrative tasks involving electronic chart analysis and document coordination, ensuring that all criteria are met and maintained according to organizational and departmental compliance standards. This role requires interaction with various internal customers, including hospital staff, physicians, and other revenue cycle team members, to facilitate effective communication and compliance with documentation standards. The HIM QA Analyst will be responsible for conducting thorough analyses and re-analyses of medical records to ensure their completeness, accuracy, and timeliness. This includes serving as the primary contact and trainer for physicians regarding documentation in the Electronic Medical Record (EMR) system. The analyst will monitor and provide feedback to physicians and other providers about TJC and CMS standards, as well as Medical Staff Bylaws, to ensure compliance in the workplace. Additionally, the analyst will perform research and follow-up to track and clarify any missing or incomplete patient health information, assigning appropriate deficiencies for incomplete medical records. In this role, the HIM QA Analyst will assist various customers in understanding chart completion requirements and will generate deficiency and delinquency letters to notify physicians of outstanding issues with documentation. The analyst will maintain the integrity of chart completion systems and manage the suspension notification process for unresolved delinquencies. Ongoing record reviews will be performed to identify compliance opportunities, and statistical reports will be prepared for the Medical Records Committee. The analyst will also be responsible for managing electronic documents and dictations, ensuring continuity of patient care, and collaborating with various departments to maintain the financial viability of the UMC Revenue Cycle. Overall, this position is vital to improving the accuracy, effectiveness, productivity, and efficiency of the department and UofL Health.

Responsibilities

• Perform analysis and re-analysis of the medical record to ensure completeness, accuracy, and timeliness of clinical documentation and compliance with regulatory bodies.
• Serve as the primary contact person and trainer of the physicians in the completion of documentation in the EMR.
• Monitor, provide feedback, and educate Physicians and other providers regarding TJC and CMS standards and Medical Staff Bylaws to ensure workplace and regulatory compliance.
• Perform research and required follow up to obtain, track, and clarify missing, incomplete or questionable patient health information as well as assign appropriate deficiencies for incomplete medical records.
• Assist customers (physicians, patient care units, quality, and other departments internally and externally, etc.) in understanding chart completion requirements.
• Generate and disseminate deficiency and delinquency letters to notify and/or provide helpful reminders to physicians of any outstanding issues with missing documentation, signatures, queries, etc., in a timely manner as established in hospital policy.
• Maintain integrity of chart completion systems and carry out the suspension notification process and suspension policy for unresolved delinquencies greater than 30 days as set forth by the medical staff.
• Perform quantitative and qualitative ongoing record reviews, identify documentation compliance opportunities, prepare statistical reports of trends and outcomes for Medical Records Committee, etc.
• Locate, route, track and coordinate electronic documents and dictations and manage courtesy copy distribution of transcribed reports for continuity of patient care.
• Review and abstract data in response to requests for patient medical record information and for statistical and clinical databases.
• Maintain overall financial viability for UMC Revenue Cycle through collaboration and effective communication with Care Management, Physicians, Coding, and Patient Financial Services.
• Monitor the implementation of appropriate changes to improve accuracy, effectiveness, productivity, and efficiency that support the overall goals of the department and ULH.
• Perform other duties as assigned.

Requirements

• High School education or GED required.
• Minimum of 3 years' experience in health information management practices and procedures.
• Experience in reading and understanding medical record data, familiarity with physician documentation, and medical record content.
• Experienced with performing ongoing medical records reviews for compliance with Joint Commission documentation standards under Record of Care for operative reports, H&Ps, authentication, etc.
• Knowledge of Medical Terminology acquired in a classroom setting or obtained through on the job training.
• Demonstrate excellent interpersonal, organizational, written and oral communication skills.
• Ability to operate or learn to operate multiple computer systems and software, document management system, chart tracking system, and master patient index search and retrieve.
• Ability to work independently, problem solve, and prioritize with minimal supervision and positive customer service relationships.
• Strong time management and critical thinking skills and ability to manage multiple demands.
• Knowledge of Federal, State, and HIPAA/HITECH privacy and security regulations governing confidentiality of patient health information.