Health Information Management Specialist Level II

NYC Health + Hospitals provided pay range

This range is provided by NYC Health + Hospitals. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$/yr - $/yr

Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hospitals. Located in Downtown Bronx, Lincoln is a teaching hospital renowned for its Centers of Excellence, and a recognized industry leader in the implementation of state‑of‑the‑art medical technology and best practices. Our team of highly trained and caring medical professionals is dedicated to providing the highest quality health care that is safe, compassionate, culturally competent and patient‑centered.

Comprehensive services are offered in three major primary care areas:
Medicine, Pediatrics, and Women’s Health in addition to more than eighty specialty services. At Lincoln, the safety and comfort of our patients is our number one priority.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

This class of positions encompasses supervisory and/or administrative work of varying degrees of difficulty and responsibility in the field of health information management. Performs quality review of records and/or documentation provided by clinical staff. Contributes to, and ensures the appropriateness of code and Diagnosis‑Related Group (DRG) assignment in order to facilitate consistency, accuracy, and efficiency in claims processing, data collection, and quality reporting.

All personnel perform related work. Under general supervision, directs, coordinates, and supports the daily activities and services in an assigned department(s), unit(s) or area of service.

• Validates the completeness, accuracy, and specificity of code assignments for inpatient, outpatient, and ambulatory surgery records in accordance with established coding guidelines. Ensures that all documented diagnoses and procedures are properly coded.
• Validates the accuracy of DRG assignment.
• Validates the accuracy of additional information abstracted from the clinical record.
• Monitors denials and appeals. Performs DRG denial reviews for appropriate parties. Ensures that denials are responded to in a timely manner; submits monthly reports.
• Monitors data integrity and accuracy; makes necessary data corrections and entry. Performs chart review to determine data quality.
• Identifies and reports on cases with documentation inadequacies, inconsistencies, and other issues with opportunities for improvement. Evaluates root causes and proposes corrective action for same.
• Generates physician queries as needed in order to obtain clarification of medical record documentation. Validates that physicians have been queried according to established procedure.
• Confers with coding specialists, and oversees and evaluates work performance. Provides ongoing and specific feedback to coding staff and management team regarding review findings.
• Provides education and training to new and existing health information management staff.
• Instructs physicians, nurses, health information management staff, and other appropriate personnel regarding documentation requirements as related to coding.
• Works with other departments to ensure that accurate reporting and reimbursement are facilitated.
• Assigns codes for diagnoses and procedures according to the current classification system for inpatient, outpatient, and ambulatory surgery records and in accordance with established coding guidelines.
• Performs concurrent and retrospective clinical documentation review and provides data when necessary.
• Reviews and analyzes clinical records for compliance with appropriate regulatory requirements.
• Effectively utilizes computer applications and other coding and abstracting software and hardware as necessary.
• Performs other related duties as assigned or directed.

• Assists…