The VA Northeast Ohio Healthcare System is recruiting for a Medical Records Administration Specialist (Charge Analyst). The Medical Records Administration Specialist (Charge Analyst) will function within in the Health Information Management Service (HIMS) section of Patient Care Administrative Service (PCAS).
Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Candidates must be a citizen of the United States. Non-citizens may be appointed when it is not possible to recruit qualified candidates in accordance with 38 U.S.C. § 7407(a). English Language Proficiency: MRAs must be proficient in spoken and written English. See 38 U.S.C. § 7403(f). Education or Experience: (1) Experience. Three years of creditable experience in the field of medical records that included the preparation, maintenance, and management of health records and health information systems demonstrating a knowledge of medical terminology, medical records procedures, medical coding, or medical, administrative, and legal requirements of health care delivery systems. OR, (2) Education. Successful completion of a bachelor's degree or higher from an accredited college or university recognized by the U.S. Department of Education, with a major field of study in health information management, or a related degree with a minimum of 24 semester hours in health information management or health information technology. (Transcript Required) OR, (3) Experience/Education Combination. Equivalent combinations of creditable experience and education that equals 100 percent may be used to meet basic requirements. For example, two years above high school from an accredited college or university, with 12 semester hours in health information technology/health information management, plus one year and six months of creditable experience that included the preparation, maintenance, and management of health records and health information systems meets an equivalent combination. Certification. Persons hired or reassigned to MRA positions in the GS-0669 series in VHA must meet one of the following: (1) Coding Certification through AHIMA or AAPC. Current mastery level coding certifications include: Certified Coding Specialist (CCS), Certified Coding Specialist (CCS) - Physician-based (CCS-P),Certified Professional Coder (CPC), Certified Outpatient Coder (COC), and Certified Inpatient Coder (CIC).OR, (2) HIM Certification through AHIMA. Current HIM certifications include Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA).OR, (3) Health Data Analyst Certification through AHIMA.NOTE. To be acceptable for qualifications, the specific certification must certify mastery in health data analysis. Current health data analyst certification includes Certified Health Data Analyst (CHDA). NOTE. HIMs Certification is required for all positions above the full performance level. Grandfathering Provision. All persons employed in VHA as an MRA are considered to have met all qualification requirements for the title, series, and grade held, including positive education, and registration and/or certification that are part of the basic requirements of the occupation Grade Determinations: In addition to the basic requirements listed above, the following criteria must be met when determining the grade of candidates. GS-5. None beyond basic requirements. GS-7 Experience - In addition to meeting all the basic requirements listed above, One year of creditable experience equivalent to the next lower grade level; OR, Education - Applicants who meet the GS-5 grade level may be appointed at the GS-7 grade level, if they possess a bachelor's degree from an accredited college or university in a major field of study in health information management, with an exemplary academic record as demonstrated by: 3.0 or higher-grade point average (GPA) out of a possible 4.0 GPA ("B" or better), as recorded on their official transcript or as computed based on four years of education, or as computed based on courses completed during the final two years of the curriculum; or 3.5 GPA or higher out of a possible 4.0 GPA ("B+" or better) based on the average of the required courses completed in the major field of study, or the required courses completed in the major field of study during the final two years of the curriculum. AND Demonstrated Knowledge, Skills, and Abilities i. Knowledge of current classification systems, such as International Classification of Diseases, Current Procedural Terminology, and the Healthcare Common Procedure Coding System (HCPCS). ii. Ability to effectively communicate (written and verbal) with medical center staff, patients, and external entities. iii. Ability to use data collection and analytical techniques for purposes of review, quality control, studies and analysis of health information. iv. Ability to utilize computer applications with varied functions to produce a wide range of reports, to abstract records, collect and analyze data and present results in various formats. v. Ability to work independently, adapt to shifting priorities, and meet deadlines. GS-9 Experience. One year of creditable experience equivalent to the next lower grade level that demonstrates the knowledge, skills, abilities, and other characteristics described at that level. OR, Education. Education equivalent to two full years of progressively higher level graduate education or a master's degree or equivalent graduate degree from an accredited college or university in a field directly related to health information management. AND Demonstrated Knowledge, Skills, and Abilities i. Knowledge of medical and legal requirements related to health information management and health records. ii. Ability to provide technical advice and guidance on health information management practices. iii. Skill in extracting data from various sources and analyzing health information to create reports. iv. Skill in researching, interpreting, and applying health information management guidelines. v. Knowledge of performance and process improvement techniques to develop new or improved solutions in health information management. GS-11 Experience. One year of creditable experience equivalent to the next lower grade level that demonstrates the knowledge, skills, abilities, and other characteristics described at that level. OR, Education. equivalent to three full years of progressively higher-level graduate education or a Ph.D., or equivalent doctoral degree from an accredited university or college in the field of health information management. AND Demonstrated Knowledge, Skills, and Abilities i. Skill in performance and process improvement techniques to develop and implement new or improved solutions in health information management. ii. Ability to advise management and staff, at various levels, regarding health record documentation requirements and health information management practices based on current industry standards, policies, statues, laws, and regulations. iii. Ability to plan, justify, develop, evaluate, assess, monitor, and advise on current health information management processes and recommend changes in policies or procedures. iv. Ability to determine and evaluate compliance with legal, ethical, and regulatory guidelines and accrediting bodies, as they apply to health information management. v. Ability to acquire, manage, analyze, interpret, and transform data into accurate, consistent, and meaningful information. Preferred Experience: Candidates experience that meet the full performance level GS-11. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-11. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-5 to GS-11. Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service.
Duties of the Medical Records Administration Specialist (Charge Analyst) include but are not limited to: Serves in a developmental capacity as technical specialist in health information related matters. Provides advice and guidance on the HIM program in relation to issues such as, but not limited, to documentation requirements for coding/billing, liability issues, advance directives, informed consent, scanning processes, release of information, and record control processes. Conducts research and coordinates projects and studies of record systems. Produces management reports from studies and develops an action plan. Determines the scope of the study, formulates a plan of action, and produces management reports. Analyzes work processes and recommends changes to improve performance. Assists in writing health information policies and procedures to incorporate new or revised approaches to the management of health information while ensuring that regulatory requirements are maintained when revising policies and procedures. Assists in all areas of HIM to be able to provide suggestions on process improvement and turnaround times. Incumbent assists in conducting quality assurance studies of health records. Performs work related to all areas of HIM as well as collaborates with other departments within the medical center and VISN to improve performance and patient care. Compiles, reviews, abstracts, analyzes, and interprets medical/legal data incidental to a variety of patient care and treatment activities. Reviews HIM processes and record review systems to maintain or improve turnaround time and the quality of data collection. Participates in facility committees and subcommittees related to health information and provides technical advice when necessary. Participates in training related to VHA Healthcare Information Systems such as VistA, CPRS, EHRM, and other software packages as they relate to HIM job functions. Perform basic testing and communicate changes to HIMs Leadership, who will notify departments. Troubleshoot issues and log service records for Electronic Health Record Modernization (EHRM) support if needed. Review Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) and revenue codes with HIMs Leadership, who will develop education for department heads and outside consultants to ensure compliance. Review suspended charges (workload) and provide feedback and education to HIMs Leadership for communication and training purposes. Researches third-party payer reimbursement and claim submission policies. Works with Consolidated Patient Account Center (CPAC) and National Charge Analyst for items related to hospital contracts, coding, bundling, and unbundling requirements. Reviews all newsletters and publications from insurance carriers, both via mail and website. Attends variety of meetings, conferences, and seminars as required or directed. Ensures the Charge Description Master (CDM) structure supports effective entry of all chargeable services/items. Retains a basic understanding of the hospital charge entry process and interfaces. Work Schedule: Monday - Friday, 8:00am - 4:30pm Telework: May be available as determined by agency Virtual: This is not a virtual position. Functional Statement #: 92647A, 9248A, 92649A, 92650A Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized