Company :
Allegheny Health NetworkJob Description :
GENERAL OVERVIEW:
Performs qualitative analysis and reanalysis of all inpatient/outpatient records upon discharge by review of medical record and utilizing deficiency management system in accordance wit regulatory requirements and hospital policy. Performs the suspension notification process in accordance with the Medical Staff Bylaws, Rules and Regulations. Complete job responsibilities in job description within quality standards measured by quality review audits and identified errors.
ESSENTIAL RESPONSIBILITIES:
- In accordance with Medical Staff Bylaws, Rules and Regulations, performs the suspension notification process. (30%)
- Analyzes medical records to identify documentation deficiencies to the responsible health care provider and enters the deficiencies into the deficiency management system. (20%)
- Performs re-analysis of medical records after health care providers complete the records, reviews and updates the deficiency management system. (15%)
- Performs financial analysis of medical records after all health care providers complete the records. (15%)
- Acts as an expert resource for physicians for questions regarding medical record documentation and assists in completion of records. (15%)
- Performs other duties as assigned or required. (5%)
QUALIFICATIONS:
Minimum
- Certificate or degree from college or technical school or one to three years related experience and/or training or equivalent combination of education and experience
Preferred
- 1 year with deficiency analysis and reanalysis and cross trained in two of the following functions: electronic medical record, data integrity functions, transcription outsourced duties, suspension process, performs QA on deficiency management process, data entry and/or perform system testing
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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