Coder 1 / Health Information Analyst

JOB SUMMARY:

• Responsible for supporting Health Information Management (HIM) operations through medical record documentation management, scanning, coding support, regulatory reporting, record retrieval, release of information, and maintenance of accurate and complete patient health records in compliance with applicable laws, regulations, and organizational standards.

PRIMARY JOB DUTIES:

1. Adheres to Brodstone Healthcare (BH) Healthcare’s Mission, Vision and Values.
2. Adheres to Brodstone Healthcare (BH) Standards of Behavior.
3. Demonstrate the ability to work effectively in a team environment, accept direction from supervisors, follow established work rules and procedures, and respond positively to constructive feedback.
4. Proficiency in the use of the 3M Encoder, ICD10 and CPT coding rules and regulations, electronic medical record (EMR) systems, and other Health Information Management (HIM) technologies required to perform job duties.
5. Ability to continually learn and adapt to new technology, software, and HIM processes.
6. Review and manage electronic documentation by monitoring electronic documents, and ensuring accurate record completion.
7. Perform scanning functions, including scanning complete patient charts and individual documents using desktop scanning equipment, while maintaining document integrity and quality.
8. Assist with assembling, abstracting, coding, auditing, and reviewing discharged patient medical records for completeness, deficiencies, signatures, and required reports, and route records appropriately.
9. Compile and submit required state and organizational reports, including cancer registry, birth defect registry, monthly maternity reports and other regulatory or statistical reporting requirements.
10. Assist with review, editing and transcription of medical, surgical, and clinical dictation as needed.
11. Complete birth certificates, type surgical permits, and process other required patient and clinical documentation in a timely and accurate manner.
12. Locate, retrieve, and distribute medical records and charts for medical staff, departments, and other authorized users as needed.
13. Respond to requests for the release of confidential patient health information in compliance with applicable laws, regulations, policies, and procedures, including providing appropriate information to insurance companies and other authorized entities.
14. Ensure compliance with all facility policies, procedures, standards of conduct, regulatory requirements, and the organization's Compliance Program, including participation in ongoing compliance and quality improvement activities.
15. Attend and actively participate in departmental meetings, in-service training, quality improvement initiatives, and continuing education programs.
16. Provide support and assistance to HIM department staff and other departments as needed to ensure efficient departmental operations and continuity of services.
17. Perform other duties and responsibilities as assigned.

Qualifications

EDUCATION:

• Required
  • GED or High School Diploma
• Preferred
  • Associate Degree - Health Information Management

EXPERIENCE:

• Required
  • N/A
• Preferred
  • Minimum of one-year Medical Terminology and Transcription

CERTIFICATIONS, LICENSES, REGISTRATIONS:

• Preferred
  • Coding Certificate with CCS-P or CCS. 
  • RHIT Certification

Join Brodstone Healthcare and have a lasting impact on Rural Nebraska!