Job Summary
Use the EPIC EHR Release Module within specified timeframes to find, review, and produce medical records needed for Hospital and Professional Billing claims when requested by payers, auditors, or governmental agencies.
Prepare medical records for on-site audits by agencies like CMS (Centers for Medicare & Medicaid Services), OIG (Office of Inspector General), The Joint Commission, and similar organizations to help reduce hospital liability.
When needed, provide medical records to internal departments like the Office of General Counsel, the Office of Patient Relations and Clinical Risk, Utilization Review Management, and Revenue Cycle.
Mission Statement
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Responsibilities*
OPERATIONS
- Produce and provide medical records to
- Prioritize and respond to all requests within all requirements and deadlines.
- Facilitate insurance payer access to Epic ECL (EpicCare Link) Provider Portal for catastrophic claims and other audits as defined and approved.
- Consistently evaluate processes for improvement, including communication of recommendations to leadership.
- Coordinate 'Legal Lock Up' process for patient EHRs with the Office of General Counsel.
OPERATIONS
- Partner with Revenue Cycle units to process requests for medical records and supporting documentation to substantiate claim payment audits and/or appeals.
- Coordinate with the Office of General Counsel, Patient Relations & Clinical Risk, and Accreditation & Regulatory Affairs to ensure timely and accurate production of medical records to meet legal or regulatory requirements.
- Interact with health system departments and units to produce medical records from ancillary and legacy EHR applications maintained outside the team's direct access to ensure a complete medical record is provided to partners, agencies, and payers.
PROBLEM SOLVING
- Identify issues and make recommendations for resolution and improvement.
- Participate in user acceptance testing of Epic EHR upgrades, including developing, revising, and maintaining unit training materials, policies, and procedures.
- Participate in process improvement and redesign to improve customer satisfaction, reduce costs, or meet departmental and institutional goals and objectives.
SKILLSET
- Attention to Detail: Achieves thoroughness and accuracy when accomplishing a task.
- Electronic Health Record Review: Locates, validates, and processes medical record documentation to accurately and thoroughly meet the end user's needs and purpose.
- Analysis: Analytical skills to visualize, articulate, and solve complex problems and concepts, and make decisions based on available information. Ability to analyze detailed information to determine appropriate compliance with privacy and security rules.
- Critical Thinking: Gathers and integrates critical information for solutions.
- Decision Making: Makes timely, informed decisions that consider the facts, goals, constraints, and risks.
- Independence: Ability to work independently in an ever-changing and potentially stressful environment while maintaining confidentiality.
- Teamwork: Adhere to high standards of teamwork by demonstrating adaptability, flexibility, and consistently sharing information and resources with others.
Required Qualifications*
- An Associate of Applied Science in Health Information Technology or an Associates degree in an equivalent, relevant field of study is required. An equivalent combination of experience, education, or certifications may be considered to meet this requirement.
- Two years of experience using an EHR (electronic health record), including the ability to identify and produce medical records.
- Knowledge of HIPAA, The Joint Commission standards, CMS regulations, and other regulatory agency requirements.
- Knowledge of general healthcare audit management practices demonstrated through experience in patient billing, revenue cycle, or payer audit medical records production.
- Demonstrated proficiency using Microsoft 365 tools and applications.
- Knowledge of the medico-legal aspects of health information management, medical terminology, medical treatment methods, pharmacology, patient care assessment, medical documentation requirements, and data collection.
- Ability to work independently or in a team with minimal supervision.
- Demonstrated strong interpersonal communication skills and independent problem-solving to meet customers' ongoing needs.
Work Schedule
40 Hours per week with availability Monday through Friday, with hours primarily between 7:30 AM and 4:30 PM
Modes of Work
Hybrid - the work requirements allow both onsite and offsite work and an employee has an expected recurring onsite presence. On occasion, the employee may be required and must be available to work onsite more frequently if necessitated by unit leadership.
Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.
Background Screening
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Application Deadline
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO Statement
The University of Michigan is an equal employment opportunity employer.