Description

We are looking for an HIM Audit Processor to join our team!  The Health Information Management team is growing in Central Pennsylvania. The location for the position is flexible and could be at UPMC Lititz, UPMC Hanover, or UPMC Community Osteopathic.  This is a full-time role with opportunities for a hybrid work from home schedule after training is complete!  The HIM Audit Processor will be joining a team centered environment regularly interacting with other departments and outside requesters with opportunities to participate in problem solving and process flow enhancements

Purpose:
Under direction of the System Director of ROI/LHR, performs specialized duties of finding records and assigning records for Ambulatory Practices; Payers/Billing; Third Party Payers pertaining to audits of medical records for HEDIS (Healthcare Effectiveness Data and Information), Risk Adjustment, DRG audits, Clinical Research; Department of Health; Recovery Audit Contractor.

Responsibilities:

• Performs other duties as assigned
• Promotes Mission, Vision, Values and a professional manner at all times.
• Consistently demonstrates appropriate and professional communication behavior toward care providers, patients, and co-workers. Cooperates with Management and peers to promote an environment of teamwork and collaboration.
• Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
• Assists in other office duties in times of staffing shortages or unexpected increases in work volume and assists with special projects when needed.
• Demonstrates a working knowledge of the established UPMC Pinnacle and HIM departmental policies and guidelines
• Displays professional behavior at all times, by adhering to the dress code, following the UPMC Pinnacle policy on attendance and reflect the UPMC Pinnacle Standards of Behavior
• Ensures protected health information is accessed and released in accordance with State and Federal Laws, Hospital Regulations and Department Policies.
• Prioritizes workload to meet deadlines
• Obtains complete listing of patients for payer or research auditor
• Uses EpicCARE Link Workflow when releasing patient information to a pre-configured EpicCare Link user via a web browser.
• Assigns records in Epic through Release to Inspector and/or Soarian EDM/HIM or other pre-existing systems as applicable
• Identifies pre-existing sites or Epic location of records
• Interacts with various payers, third party payers and office staff to process medical record audits.

Qualifications

• High school graduate or equivalent
• Typical knowledge of computers
• Understand and navigate patient medical records
• Analyze and resolve computer/printer problems
• Working knowledge of EPIC, OnBase
• Working knowledge of Allscripts, Athena, NextGen, Medent, eClinical
• Works or other pre-existing systems
• Strong communication and organizational skills
• Establish and maintain cooperative working relationships with others including all payers, third party payers, office staff, and medical record assistants
• Graduate of a 2 year AHIMA approved health information program preferred.
• Previous customer service preferred.

Licensure, Certifications, and Clearances:
Clearances must be dated within 90 days

• Act 33 with renewal
• Act 34 with renewal
• Act 73 FBI Clearance with renewal

UPMC is an Equal Opportunity Employer/Disability/Veteran

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Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.