Role and Responsibilities

Responsible for directing, planning, coordinating, and administering the medical records program of the hospital.

· Responsible for supervising and managing department operations and managing the function of utilization review as required by public law and any other agencies.

· Work is performed in accordance with hospital rules and regulations, the Joint Commission on Accreditation of Hospitals (JCAH), the state Board of Health (BOH), and state statutes of privileged information.

· The position reports to the Director of Finance and supervises the Assistant Director of Medical Records, Utilization Review (UR) Coordinator, and Medical Records employees.

· The Medical Records Director also interacts with administration, physicians, and other department personnel, particularly the nursing service and business office, department directors, other health providers, third-party payors, attorneys, and JCAH and state BOH surveyors and the hospital attorney.

· Responsible for meeting the requirements of the state BOH and JCAH for the Medical Records Department.

· Ensures that medical records are complete and accurate, and conform to accepted JCAH and state BOH standards, reporting to the Medical Records Committee of the medical staff any variations noted and new regulations or requirements, in accordance with standard Medical Records practices.

· Supervises the checking of charts for deficiencies. Reports physicians with delinquent charts according to the medical staff bylaws. Reports incomplete and delinquent charts to the Medical Records Committee and chairperson.

· Supervises and coordinates the activities of personnel engaged in all medical records functions, such as compiling, analyzing, coding, indexing, and filing of permanent records of patients, including microfilming.

· Trains personnel in coding, indexing, filing, preparation and display of information, transcription, medical terminology nomenclature and classification of diseases, and computer services, including such related matters as hospital organization, goals, policies and practices, and medical records ethics. Periodically may be requested to provide other employees in the hospital with medical terminology classes.

· Supervises and monitors the release of confidential information in accordance with rules and regulations, federal regulations, and state statutes of privileged information for requests from insurance companies, attorneys, patients, and subpoenas.

· Responsible for compiling statistical information and registers pertaining to the Medical Records Department, Ancillary Services, and other hospital statistical information as assigned or requested. Supervises and coordinates the preparation of statistical information for the medical staff, medical staff committees, accreditation agencies, state agencies, and the administration.

· Participates and represents the Medical Records Department in various hospital committees and medical staff committees as assigned.

· Informs medical staff committees of requirements or new regulations of the JCAH, state BOH, or other regulatory agencies.

· Responsible to appear in court upon receipt of a subpoena to testify to the authentication of medical records. Abides by the state peer review statute.

· Monitors and oversees the requisition of supplies for the Department. Responsible for recommending equipment needs to ensure efficient handling of responsibilities.

· Responsible for the distribution in changes of workloads, hours, overtime hours, salary adjustments, and evaluation of employees. Also is responsible for the preparation of the Payroll Hours Analysis Report.

· Manages computer services such as the abstracting service and the tumor registry.

· Responsible for the surveillance of communicable diseases and reporting to the state BOH through the Infection Control Officer.

· Responsible for reporting vital records such as birth certificates and death certificates to the state BOH (upon request only).

· Responsible for the management of the utilization review requirements of the medical staff and hospital to meet state BOH, JCAH, and intermediary regulations.

· Responsible for knowing the requirements of utilization review; understanding the necessity and benefits of maintaining satisfactory denial rates for reimbursement guarantees. Responsible for reporting to the UR Committee of the medical staff any variations or new regulations or requirements. Responsible for recommending to the UR Committee procedures or diagnoses for review procedures.

· Provides diagnosis codes to the Fiscal Services Department on a timely basis in order to expedite filing on insurance claims for patient services rendered, as required by hospital and external agencies.

Work Context

Requires sitting, Requires telephone conversations, Requires use of electronic mail, Requires writing letters and memos, Requires face-to-face discussions with individuals or teams, Requires contact with others (face-to-face, by telephone, or otherwise), Requires competition or awareness of competitive pressures, Requires dealing with unpleasant, angry, or discourteous people, Includes conflict situations, Mistakes are not easily correctable and have serious consequences, Opportunity to make decisions without supervision, Requires making decisions that affect other people, the financial resources, and/or the image and reputation of the organization, Requires making decisions that impact the results of co-workers, clients or the company, Requires being exact or highly accurate, Freedom to determine tasks, priorities, and goals, Requires meeting strict deadlines, Requires coordinating or leading others in accomplishing work activities, Requires work with others in a group or team, Includes responsibility for the health and safety of others, Includes responsibility for work outcomes and results, Requires working indoors in environmentally controlled conditions

Work Related Activities

· Developing Objectives and Strategies

· Training and Teaching Others

· Evaluating Information to Determine Compliance with Standards

· Developing and Building Teams

· Organizing, Planning, and Prioritizing Work

· Establishing and Maintaining Interpersonal Relationships

· Provide Consultation and Advice to Others

· Documenting/Recording Information

· Communicating with Supervisors, Peers, or Subordinates

· Communicating with Persons Outside Organization

· Updating and Using Relevant Knowledge

· Performing Administrative Activities

· Identifying Objects, Actions, and Events

· Interpreting the Meaning of Information for Others

· Processing Information & Thinking Creatively

· Making Decisions and Solving Problems

· Getting Information

· Interacting With Computers

· Resolving Conflicts and Negotiating with Others

· Coaching and Developing Others

· Monitoring and Controlling Resources

· Implement Employee Benefit Plans

· Orient New Employees

· Resolve Worker Conflicts

· Use Interviewing Procedures

· Explain Rules, Policies Or Regulations

· Conduct Or Attend Staff Meetings

· Maintain department Job Descriptions

· Develop Training Programs

· Confer With Other Departmental Heads To Coordinate Activities

· Prepare Reports For Management

· Use Conflict Resolution Techniques

· Communicate Technical Information

· Use Negotiation Techniques

· Use Project Management Techniques

· Participate In Staff Training Programs

· Oversee Execution Of Organizational Or Program Policies

· Analyze Operational Or Management Reports Or Records

· Develop Policies, Procedures, Methods, Or Standards

· Use Interpersonal Communication techniques

Qualifications and Education Requirements

• Must be a high school graduate or equivalent AND possess an ART or RRA certificate.
• 2-5 years experience in management.

Preferred Skills

Administration and Management Customer and Personal Service English Language Mathematics Psychology

Thorough knowledge of accepted hospital medical-records practices, including medical records ethics, classification, and nomenclature. Ability to interpret Medical Records Department policies and procedures and apply them in specific situations. Thorough knowledge of federal and state regulations, laws, and UR Committee planning, organization, and management. Must have knowledge of medical staff bylaws, rules, and regulations, and the state peer review statute.

Skills

Active Learning Active Listening Critical Thinking Learning Strategies Mathematics Monitoring Reading Comprehension Science Speaking Writing Coordination Instructing Negotiation Persuasion Service Orientation

Social Perceptiveness Complex Problem Solving Time Management Spreadsheets Presentations Internet

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