HIM SPECIALIST

Definition and Role

Under the direction of the Assistant Director of Revenue Cycle – Coding & Medical Records, the HIM Specialist is responsible for entering information into the facility’s database using medical coding protocol to produce a statement or claim for Home Health. Acts as a liaison between the facility and payment parties, investigate the claim, verify its information, and update the database. A non-exempt, clerical position responsible for gathering, processing, and maintaining patient medical records. Acts as a liaison between the facility and payment parties, investigate the claim, verify its information, and update the database. Ensure medical records are maintained in a manner compliance with ethical, legal, and regulatory requirements of the medical services system.

Job Responsibilities and Duties

• Verify and enter patient demographic and insurance information into practice management software Abstract information from medical record and assign appropriate codes, as necessary.
• Coordinate with Clinic Manager’s as needed for document signatures.
• Print/Upload medical records and prepare for billing.
• General sorting, filing, scanning, and faxing of documents and other duties as assigned.
• Submit claims to third party insurance carriers either electronically or by hard copy billing.

Qualifications

• Must be driven and self-disciplined, especially if thinking of working in medical billing and coding from home.
• Being organized is essential since you will be dealing with patient files and documents.
• Attention to detail is also an important job requirement, as typos and inaccuracies can happen easily when using medical coding as a means of communication.
• Proper phone etiquette is necessary since phone conversations with providers and insurance carriers will be frequent.
• Basic knowledge of ICD 10-CM coding.
• Basic knowledge in Microsoft Excel.
• Understand & apply medical terminology.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing this job the employee is frequently required to sit, talk, and hear.
• The employee is occasionally required to walk, use hands and fingers to feel, handle, or operate objects, tools, or controls, and reach with hands and arms.
• The employee must occasionally lift and/or move objects weighing up to 25 pounds.
• Specific vision abilities required by this job include close vision and the ability to adjust and focus.
• Emotional/Psychological: Constant ability to make decisions and concentrate.