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Job Summary

Utilize the EPIC Release Module to locate, analyze, and produce medical records required to substantiate Hospital and Professional Billing claims in response to payer, auditor, and government agency requests.

Process medical record requests for on-site regulatory audit requests for CMS (Centers for Medicaid/Medicare Services), OIG (Office of Inspector General), The Joint Commission, and related entities to ensure appropriate follow-through and assist in the minimization of hospital liability. Provide medical records to internal customers, such as the Office of General Counsel (OGC), the Office of Patient Relations and Clinical Risk, Utilization Review Management, and Revenue Cycle as requested or required. Process requests for required medical records within designated time limits.

Represent the unit professionally and provide support and customer services to all internal and external record review requesters.

What You'll Do

OPERATIONS

Provide medical records to the Office of General Counsel (OGC), the Office of Patient Relations and Clinical Risk, Utilization Management, and Revenue Cycle departments upon requestCoordinate "Legal Lock Up" process with the Office of General CounselPerform medical record release tracking related to audits and appeals activity in the MiChart Audit and/or MiChart Release of Information modules as appropriate and directedVerify and process "Authorization to View" form requests from health system employeesProvide assistance to remote auditors as requested (or other users as defined and approved) in accessing the electronic health record via the ECL (EpicCare Link) Provider PortalPrioritize and respond to medical record requests to meet all time and documentation requirementsWork with other Michigan Medicine staff using existing process standards to ensure that documentation necessary to support appropriate billing is in the record and available to auditing staff for review Ability to identify and communicate nuances and/or trends in incoming requests for medical records.Work under fast-paced circumstances to meet deadlinesIdentify issues and make recommendations for resolution and improvementCommunicate with unit leadership regarding process and proceduresAssist with development, revision and maintenance of unit training materials, policies, and proceduresDemonstrate an understanding of university, departmental, and unit policies and procedures and seek clarification as neededComply with regulatory, legal, and accreditation requirements and seek clarification if neededAssure compliance with safety programsParticipate in and demonstrate an understanding of the Michigan Quality System/Continuous Quality Improvement and apply Lean Thinking concepts in daily workDemonstrate initiative by continuous expansion of knowledge and skillsParticipate in departmental/unit activities including, but not limited to, staff meetings and in-services

CUSTOMER SERVICE

Interact with and advise personnel from the Office of Patient Relations and Clinical Risk, Professional Services, the Office of General Counsel, and specialty departments to ensure requests for medical records are fully resolvedResolve customer requests in accordance with governmental regulations and Michigan Medicine policies and proceduresWork in collaboration with the release of information vendor, satellite clinics, and the Document and Record Management Unit to ensure all requested records are available online or for delivery to internal and external requesters within required time frames  Work in partnership with Revenue Cycle employees to process requests for medical records and supporting documentation to substantiate claim payment audits and/or appeals. Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.  Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Responsibilities*

PERCENTAGE OF DUTIES

Identify and produce electronic and/or paper medical records for auditors, payers, and regulatory requirements under predetermined timelines (including legacy source systems). 70%Participate in unit-specific, department-wide, or UMHS-initiated process improvement efforts. 10%Partner with other Revenue Cycle colleagues (e.g., Hospital Billing, Audits and Appeals) to ensure complete and timely production of medical records. 5%Coordinate remote record reviews; provide system access and training and assist remote auditors. 5%Certify the accuracy of medical record information for legal certification. 5%Identify issues/make recommendations or improvements. 5%Skills You HaveAttention to Detail: Achieves thoroughness and accuracy when accomplishing a task.Electronic Health Record Review: Locates, validates, and processes medical record documentation so its accessibility, reliability, and timeliness are ensured to satisfy the needs of end-users  Analysis: Analytical skills with the ability to visualize, articulate, and solve complex problems and concepts and make decisions based on available information. Ability to analyze detailed information to determine appropriate compliance with privacy and security rulesCritical Thinking: Gathers and integrates critical information to arrive at effective solutionsDecision Making: Makes timely, informed decisions that consider the facts, goals, constraints, and risks.Required Qualifications*An Associate of Health Information Technology or equivalent education and experience is required.1 year of experience using an electronic health record (e.g., EPIC) and administrative systems is required.Ability to read and understand complex medical documentation is requiredKnowledge of general healthcare audit management practices is requiredAbility to work independently or in a team with minimal supervision is requiredAbility to assess and extract appropriate clinical information from a patient's medical record is required.Knowledge of medico-legal aspects of health information management, medical terminology, medical treatment methods, pharmacology, patient care assessment, medical documentation requirements, and data collection techniques is requiredConsiderable experience with Windows computer environment and proficiency with MS Office is requiredKnowledge of The Joint Commission standards, CMS regulations, and other regulatory agency requirements Maintaining active certification (as applicable) and American Health Information Management Association membership is required (as applicable)1 year of experience in producing medical records from an EHR application.Desired Qualifications*Experience using UMH Michigan Medicine EHR (MiChart) is desired.Associates Degree in Health Information Technology or Bachelor's Degree in Health Information Management or Healthcare Administration desiredCertified Revenue Cycle Representative certification through the Healthcare Financial Management Association) desiredKnowledgeable of Revenue Cycle processes including billing, insurance and/or coding practicesExperience working with insurance companies and third-party payers is desired.  Understanding and ability to interpret medical terminology and insurance benefit information is desiredCertification as a Registered Health Information Administrator (RHIA) or a Registered Health Information Technician (RHIT) through the American Health Information Management Association (AHIMA) or an equivalent combination of education, professional certification, and experience is desiredWork ScheduleStandard business hours Monday through Friday between 7:30 AM and 4;00 PM. Flexibility to scheduled hours upon supervisor approval.Hybrid training is required for this position and will take place onsite at the KMS office location and remotely via Microsoft Teams and/or ZoomThis is a primarily remote position once training is completed and performance-based
competency has been achieved.The position requires a weekly (1 day) onsite rotation to support unit operations unless otherwise approved or accommodatedModes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Additional Information

SUPERVISION RECEIVED

General supervision is received from the Revenue Cycle Mid-Service, HIM Supervisor of Compliance and AuditingBackground Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for at least seven calendar days. The review and interview process may begin at any time during the posting period, and selection may occur as early as the eighth day after posting. This opening may be removed from posting boards and filled any time after the minimum posting period has ended.

U-M EEO/AA Statement

The University of Michigan is an equal opportunity/affirmative action employer.