This position is in the Health Information Management (HIM) Section of Health Administration Service (HAS) at the VA Northern Indiana Health Care System (VANIHCS). Medical Records Administration Specialist (MRAS) in VHA performs work concerned with the management of a health record program or the provision of services related to medical record administration/health information services.
Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. 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 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.] OR 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 - You must have one of the below: Coding Certification through AHIMA or AAPC. Mastery certification obtained through the American Health Information Management Association (AHIMA) or the American Association of Professional Coders (AAPC). To be acceptable for qualification, the specific certification must represent a comprehensive competency in the occupation. Stand-alone specialty certifications do not meet the definition of mastery level coding certification and are not acceptable for qualifications. Certification titles may change and certifications that meet the definition of mastery level coding certification may be added/removed by the above certifying bodies; however, 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 HIM Certification through AHIMA. Higher-level health information management certification is limited to certification obtained through AHIMA. To be acceptable for qualifications, the specific certification must represent a comprehensive competency in the occupation. Certification titles may change and certifications that meet the definition of HIM certification may be added/removed by the above certifying body; however, current HIM certifications include Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA); OR Health Data Analyst Certification through AHIMA. This is limited to certification obtained through AHIMA. To be acceptable for qualifications, the specific certification must certify mastery in health data analysis. Certification titles may change and certifications that meet the definition of health data analyst certification may be added/removed by the above certifying body; however, current health data analyst certification includes Certified Health Data Analyst (CHDA). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS 05 Experience or Education. None beyond basic requirements GS 07 Experience. One year of creditable experience equivalent to the GS-5 grade level; OR Education. Successful completion of 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 A 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 A 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. Candidates must also demonstrate all of the knowledge, skills, and abilities below: Knowledge of current classification systems, such as International Classification of Diseases, Current Procedural Terminology, and the Healthcare Common Procedure Coding System (HCPCS). Ability to effectively communicate (written and verbal) with medical center staff, patients, and external entities. Ability to use data collection and analytical techniques for purposes of review, quality control, studies and analysis of health information. 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. Ability to work independently, adapt to shifting priorities, and meet deadlines. GS 09 Experience. One year of creditable experience equivalent to the GS-7 grade level that demonstrates the knowledge, skills, abilities, and other characteristics described at that level; OR Education. Successful completion of 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. Candidates must also demonstrate all of the knowledge, skills, and abilities below: Knowledge of medical and legal requirements related to health information management and health records. Ability to provide technical advice and guidance on health information management practices. Skill in extracting data from various sources and analyzing health information to create reports. Skill in researching, interpreting, and applying health information management guidelines. 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 GS-9 grade level that demonstrates the knowledge, skills, abilities, and other characteristics described at that level; OR Education. Successful completion of 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. Candidates must also demonstrate all of the knowledge, skills, and abilities below: Skill in performance and process improvement techniques to develop and implement new or improved solutions in health information management. 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. Ability to plan, justify, develop, evaluate, assess, monitor, and advise on current health information management processes and recommend changes in policies or procedures. Ability to determine and evaluate compliance with legal, ethical, and regulatory guidelines and accrediting bodies, as they apply to health information management. Ability to acquire, manage, analyze, interpret, and transform data into accurate, consistent, and meaningful information. 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-05 to GS-11.
Duties include, but are not limited to: Assists the Chief, Health Information Management (CHIM) and the HIM Department in identifying and setting short- and long-range goals, program objectives and tasks to meet the mission and vision of the VAMC. 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 department heads and outside consultants to ensure compliance. Develop process documents for charge error resolution and maintain process documents for revenue integrity procedures. Educate departments regarding charge reconciliation procedures and revenue integrity principles. Assist the OI&T System Analysts with conversion or upgrade preparation, to include testing and analysis of revenue; tracing transactions from Charge Entry to Interface to Billing to Financial Accounting. Research third party payer reimbursement and claim submission policies and educates facility staff on reimbursement requirements to ensure clinical documentation supports reimbursement; 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, and abstracts vital information relative to established billing protocol and/or changes for distribution to clinical and administrative staff, compliance, and field locations. Ensures the Charge Description Master (CDM) structure supports effective entry of all chargeable services/items. Retains a thorough understanding of the hospital charge entry process and interfaces. Serves as an expert in all subjects related to the Charge Description Master for clinical departments, hospital management, revenue cycle team, administration, and others. Interfaces with clinical/ancillary departments to ensure that charge codes accurately reflect services provided. Coordinates with other Revenue Cycle staff on quarterly/annual department CPT/HCPCS coding and CDM maintenance updates to coincide with the CMS annual updates to the Hospital Outpatient Prospective Payment System. Provides subject matter expertise to Service Line Leaders, and medical center staff. Interprets and applies The Joint Commission (TJC) standards, VA regulations and medico-legal requirements; current Federal Codes pertinent to health records; Veterans Administration policy memoranda, directives and handbooks pertinent to health information management; medical coding (ICD, CPT, HCPCS) and reimbursement methodologies; medical and procedural terminology; anatomy and physiology, regulations governing confidentiality of health records; release of information laws and statutes; and all policies/procedures pertaining to VHA health records. Keeps current on emerging issues and trends in the health information management field, including process improvement initiatives for HIM, the electronic health record, coding and computer assisted coding, the revenue cycle, release of information and privacy issues, records management, transcription and data entry, and health information exchange. Perform audits and analysis, preparing and presenting findings and recommendations to the CHIM, Service Line Leaders and medical staff. Advises Principal Investigators and other clinical staff relating to methodologies of retrieving health care data for specific studies. Performs data retrieval for special studies as needed. Reviews and test HIM related VistA software patches; test and trouble-shooting VistA menu options and functional issues when HIM users report application errors; perform equipment needs analysis for new or replacement equipment and/or equipment repair; submit work orders or Remedy tickets for correction to HIM software errors. Serves as the point of contact for health record corrections. Documentation corrections may consist of retracting erroneous notes, re-titling notes, assigning notes to or removing from consult requests. Establishes criteria and provides education when dealing directly with physicians, nurses and other clinical providers requesting them to complete or adjust pertinent parts of the health records, which are found to be inconsistent or incomplete upon analysis. Work Schedule: Monday - Friday, 8:00 AM - 4:30 PM Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 92618A, 92619A, 92620A, 92621A Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service