Job Description

Job Description

Job Description

Job Summary: To manage the medical records department and ensure

DUTIES AND RESPONSIBILITIES:

Demonstrates Competency in the Following Areas:

• Responsible for new admission demographics and information into PCC
• PCC Security Officer – Enters new employees into system
• Completes MD, NP, PA credentialing
• MDS MD scheduled visits – 30,60,90 day etc
• Upload ancillary recommendations, visits into PCC
• Fax face sheet to pharmacy, lab , x-ray
• HMO and Medicare appeals management
• Gather and organize mailings, track dates, maintain spreadsheet in shared drive
• Manage and arrange appointments and transportation – use Med Rec support and/or other facility delegate support
• Maintain communications with third party payers and send documentation requests and maintain file of communication on a case by case basis
• Chart Set up, filing and thinning process management
• Manage QA chart audit process as defined and directed by QA Committee
• Medicare beneficiary notice process audit
• Denial management process...ADR and Appeals
• Hi/Low risk chart audits (define)
• PCC user and security review
• Manage Medical Record Storage and destruction
• Obtain auths from third party payers for Part B therapy
• QA audits as defined and directed by facility administration
• PRI – verify current one in house and valid
• Manage MDS uploads either manual or automatic
• Weekly Census upoad
• HIPPA Security Officer
• Reports to QUAPI
• Load new admission demographics and information into PCC
• PCC Security Officer
• MD, NP, PA credentialing
• MDS MD scheduled visits – 30,60,90 day etc
• Upload ancillary recommendations, visits into PCC
• Fax face sheet to pharmacy, lab , x-ray
• HMO and Medicare appeals management
• Diagnosis Management
• Accuracy and priority order of DX
• Ensure Diagnosis and ICD-10 are accurate 
• Responsible to maintain active versus inactive diagnosis coding within Electronic Health Record
• Maintain current diagnosis list with Electronic Health Record
• Maintains accurate log of discharge letters and ensure timely submission to Ombudsman

Professional Requirements:

• Adheres to dress code, appearance is neat and clean.
• Leads by example
• Maintains regulatory requirements.
• Maintains confidentiality at all times.
• Reports to work on time and as scheduled, completes work within designated time.
• Wears identification while on duty, uses computerized time system correctly.
• Delivers Excellent Customer Service
• Attends annual review and department inservices, as scheduled.
• Commits to quality outcomes
• Represents the organization in a positive and professional manner.
• Actively participates in performance improvement and continuous quality improvement (QAPI) activities.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission, vision and goals of the facility.
• Completes annual education requirements.
• Promotes the success of others and a positive work environment

Language Skills:

• Able to communicate effectively in English, both verbally and in writing.
• Additional languages preferred.

Skills:

• Basic computer knowledge.

Physical Demands:

• For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising resident care.

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