At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
General Description of the Job Class
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, and require interpretation and explanation of policy and external requirements related to privacy, the release of information, positive patient identity, and other departmental and organization-wide functions. Specific job responsibilities are based on the service unit within the Health Information Management assigned. Expert computer skills in navigating and querying multiple electronic record systems.
Release of information: regular interaction is required with patients, attorneys, governmental agencies, health care providers, 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.
Duties and Responsibilities of this Level
Release of Information Functions:
Review requests for medical records to identify dates of service, entity, provider, and specific clinical documents requested. Works extensively in the electronic health record and decentralized electronic databases to locate specific clinical documents to fulfill a request.
Review patient authorizations to validate HIPAA-required elements and validate the legal authority of the requestor. Reviews NC and State Subpoenas and Court Orders to determine if valid and returns to the requestor if deemed invalid.
Coordinate visits from Health Plan Reviewers and Research Monitors through the provision of electronic medical records, assignment of passwords, and deactivating passwords at the conclusion of the visit. Assists the reviewer in locating specific documents as needed.
Reviews requests for patient amendments, locates disputed documents in the electronic health record and notifies providers of patient requests for amendment. Tracks amendment requests to ensure the patient is notified of the outcome within the HIPAA-required timeframe.
Obtains Itemized Statements from PRMO Self Pay and uses them to calculate lien balances and generate At tourney Lien letter and forwards Itemized Statement to the requestor as needed.
Obtains provider approval to release psychiatric encounter records when requested by the patient and seeks provider approval to release records for minor patients ages 12-17 to parents to comply with additional privacy protections under NC Statute and Federal Law.
Accompanies certified copies of 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.
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 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 is 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.
Minimum Qualifications
Education
High School diploma required; preferred Associate's degree in Health Information Management or related field.
Experience
Four years of experience in a healthcare-related field are required, two of which must be in Health Information Management Candidates with an Associate's degree in HIM require two years of healthcare experience and one year of HIM-specific experience Candidates with a Bachelor's degree in HIM require two years of healthcare experience Candidates with a Bachelor's degree in Health Care require two years of HIM-specific experience.
Degrees, licenses, and certifications
preferred: RHIT/RHIA/CHPS/CHDA
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.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.