Parkland Looking for HIM Health Record Quality Analyst I at Dallas, TX Full Time

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

Primary Purpose:

Audits and analyzes the work processes, policies and procedures for regulatory compliance issues. Monitors the implementation of appropriate changes to improve accuracy, effectiveness, productivity, and efficiency that support the overall goals of the department and Parkland and ensure workplace and regulatory compliance.

Minimum Specifications:

Education:
– Must have a Bachelor’s degree in a health related field.

Experience:
– Must have five years experience auditing compliance with federal and state legislation, and/or five years of patient care experience
– Professional nursing experience preferred.

Equivalent Education and/or Experience:
– May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.

Certification/Registration/Licensure:
– None

Responsibilities

1. Audits established clinical and operational processes, policies and procedures to detect errors or irregularities and ensure compliance with all laws, regulations and guidelines of Federal and State programs.

2. Tracks progress of HIM compliance program work plan assignments, prepares and presents written reports to the Compliance Committee to document auditing activities.

3. Conducts limited scope charge capture reviews to ensure the accuracy of the charge capture process and revenue maximization.

4. Maintains knowledge of applicable areas. Participates in the establishment of written policies and procedures regarding billing, fraud, waste or abuse to ensure ethical standards of conduct among Parkland employees and effective internal controls that promote adherence with applicable state/federal laws, and the program requirements of accreditation agencies, and federal, state, and private health plans.

5. Assists with investigations, documents and reports suspected violations and irregularities to ensure prompt corrective action and/or resolution of the issue. Coordinates efforts with Reimbursement, Quality Management, Corporate Compliance, and Legal Affairs as needed.

6. Maintains a positive relationship with departments throughout Parkland and outside contacts to ensure direct access, communication and cooperation with planning, implementing and monitoring compliance issues.

7. Assists with non-compliance related audits as needed and provides expertise to audits of Parkland to ensure assets are safeguarded, internal controls are present, resources are used efficiently, and that all activity and costs are appropriate.

8. Serves on various interdisciplinary committees as assigned.

Job Accountabilities

• Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
• Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
• Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.

Skills or Special Abilities:

• Must be able to utilize knowledge regarding the care of the patient and be familiar with medical record coding/abstracting, as well as CMS guidelines.
• Must have the knowledge and ability to interpret government regulations which apply to Parkland and employ effective problem-solving skills to make appropriate recommendations for process improvement.
• Must be able to write detailed reports of findings and recommendations.
• Must demonstrate effective interpersonal and communication skills.
• Must be able to demonstrate knowledge and skills to operate a personal computer to input and extract information using word processing, spreadsheet, and database software.

Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.